CIHM 
Microfiche 
Series 
(Monographs) 


ICMH 

Collection  de 
microfiches 
(monographles) 


Canadian  Instituta  for  Historical  MIcroraproductiont  /  Institut  Canadian  da  nriicroraproductiont  historiquas 


Technical  and  Bibliographic  Notes  /  Notes  techniques  et  bibliographiques 


The  Institute  has  attempted  to  obtain  the  best  original 
copy  available  for  filming.   Features  of  this  copy  which 
may  be  bibliographically  unique,  which  may  alter  any 
of  the  images  in  the  reproduction,  or  which  may 
significantly  change  the  usual  msthod  of  filming,  are 
checked  below. 


0  Coloured  covers/ 
Couverture  d«  couleur 


0 


Covers  damaged/ 
^  I  Couverture  endommagte 


□  Covers  restored  and/or  laminated/ 
Couverture  resUuree  et/ou  pellicula* 


n 


Cover  title  missing/ 

Le  titre  de  couverture  manque 


□  Colour**!  maps/ 
Caites  giographiques  en  couleur 

□  Coloured  ink  (i  e.  other  than  blue  or  black)/ 
Encre  de  couleur  (i.e.  autre  que  bleue  ou  noirel 


Coloured  plates  and/or  illustrations/ 
Planches  et/ou  illustrations  en  couleur 

Bound  with  other  material/ 
Relie  avec  d'autres  documents 


D 


,  I  Tight  binding  may  cause  shadows  or  distortion 
^  '  along  interior  margin/ 

La  reliure  serr*e  peut  causer  de  I'ombre  ou  de  la 
distorsion  le  long  de  la  marge  interieure 


□  Blan 
with 


Blank  leaves  added  during  restoration  may  appear 

iin  the  tent    Whenever  possible,  these  have 
been  omitted  from  filming/ 
II  sa  peut  que  certainei  pages  blanches  a|outies 
lurs  d'une  restauration  apparaissent  dans  le  texte, 
mais,  lorsque  cela  etait  possible,  ces  pages  n'ont 
pas  ete  film^s. 


L'Institut  a  microfilm^  le  meillcur  exemplaire  qu'il 
lui  a  eti  possible  de  se  procurer.   Les  details  de  cet 
exemplaire  qui  sont  peut-itre  uniques  du  point  de  vue 
bibliographique,  qui  peuvent  modifier  une  image 
reproduite.  ou  qui  peuvent  exiger  une  modification 
dans  la  methode  normale  de  filmage  sont  indiques 
ci-dessous. 


□  Coloi 
Pages 


Coloured  pages/ 
da  couleur 


0  Pages  damaged/ 
Pages  endommagees 


n 


Pages  restored  and/or  laminated/ 
Pages  restaurees  et/ou  pellicul^s 


Q  Pages  discoloured,  stained  or  foxed/ 
Pages  decolorees,  tachetees  ou  piquees 


n 


HSh 
Tr 


Pages  detached/ 
Pages  detachees 


Showthrough/ 
ansparence 


□  Quality  of  print  varies/ 
Qualite  inegale  de  I'lmpression 


n 

I     71  Inclu 
lid  Com, 


Continuous  pagination/ 
Pagination  continue 


ides  index(es)/ 
Comprend  un  (des)  index 


Title  on  header  taken  from:  / 
Le  titre  de  TentCte  provient' 


n  Title  page  o*  issue/ 
Page  de  titre  de  la  li 

□  Caption  of  issue/ 
Titre  de  depart  de  la  li 

n 


ivraison 


vraiton 


Masthead/ 

Generique  (piriodiques)  de  la  livraison 


S  Additional  comments  /  Pagination   is   as    follows:    p.    11-258,    [1]-16. 

Commentaires  supplementaires:     Copy    has   manuscript    annotat  lon.s  . 

This  Item  IS  filmed  at  the  reduction  ratio  checked  below/ 

Ce  document  est  filme  au  taux  de  reduction  mdique  ci  dessous 


lUx 


14X 


22  X 


."bX 


]0x 


! 
1 

1         — \ — 
L,   I  .,_u_j — 

/' 

1  1       ! 

MX 


itx 


20X 


2«x 


l%\ 


3:« 


The  copy  filmed  h«r«  has  b««n  r«produc*d  thanks 
to  ths  ganarosity  of: 

Academy  of  Medicine  Collection 
The  Toronto  Hospital 

Tha  imagaa  appaaring  hara  ara  tha  bast  quality 
possibia  conaidaring  tha  condition  and  lagibility 
of  tha  original  copy  and  in  kaaping  with  tha 
filming  contract  spacifications. 


L'axamplaira  fUmi  fut  reproduit  grice  i  la 
gAnArositA  da: 

Academy  of  Medicine   Collection 
The  Toronto  Hospital 

Las  imagas  suivantas  ont  iti  raproduites  avec  la 
plus  grand  soin.  compte  tenu  da  la  condition  at 
da  la  nattat*  da  l'axamplaira  filmA.  at  en 
conformity  avac  las  conditions  du  contrat  da 
filmaga. 


Original  eopias  in  printed  papar  covars  ara  fllmad 
beginning  with  tha  front  covar  and  ending  on 
tha  last  page  with  a  printed  or  illustrated  imprea- 
sion,  or  the  back  cover  when  appropriate.  All 
other  original  copies  are  filmed  beginning  on  the 
first  page  with  a  printed  or  illustrated  impree- 
sion,  and  ending  on  the  last  page  with  a  printed 
or  illustrated  impression. 


Les  exemplairas  originaux  dont  la  couvartura  an 
papier  est  imprimte  sont  filmAs  an  commandant 
par  la  premier  plat  at  an  tarminant  soit  par  la 
darniire  page  qui  comporte  una  empreinte 
d'imprassion  ou  d'illustration,  soit  par  la  second 
piak,  salon  la  cas.  Tous  las  autres  exemplairas 
originaux  sont  filmis  an  commandant  par  la 
premiere  page  qui  comporte  une  empreinte 
d'impreasion  ou  d'illustration  at  an  tarminant  par 
la  darniAre  pege  qui  comporte  une  telle 
empreinte. 


The  laat  recorded  frame  on  eech  microfiche 
shall  contain  the  symbol  ~^  (meaning  "CON- 
TINUED"), or  the  symbol  y  (meaning  "END  "). 
whichever  applies. 


Un  des  symboles  suivsnts  apparaitra  sur  la 
darniire  image  de  cheque  microfiche,  seion  le 
cas:  le  symbols  — »>  signifie  "A  SUiVRE".  le 
symbols  ▼  signifie  "FIN". 


Maps,  plates,  charts,  etc.,  may  be  filmed  at 
different  reduction  ratios.  Those  too  large  to  be 
entirely  included  in  one  exposure  are  filmed 
beginning  in  the  upper  left  hand  corner,  left  to 
right  and  top  to  bottom,  as  many  frames  as 
required.  The  following  diegrams  illuatrata  the 
method: 


Les  cartas,  planchea,  tableaux,  etc..  peuvent  itre 
filmte  A  des  taux  de  reduction  diffirents. 
Lorsque  le  document  est  trop  grand  pour  ttra 
reproduit  an  un  seul  clichi,  il  est  film*  A  partir 
oa  Tangle  supArieur  gauche,  de  gauche  k  droita. 
at  da  haut  an  bas.  en  prenant  la  nombre 
d'imeges  nicessaira.  Las  diagrammas  suivants 
illustrant  la  m^thoda. 


1 

2 

3 

1 

2 

3 

4 

5 

6 

4 


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felt'ij 


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of  Human  Anatomy 


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ATLAS  AND  TEXT-BOOK 


HUMAN    ANATOMY 


BV 


DR.  JOHANNES  SOBOTTA 

PKUFESSIIR    OK    ANATOMY    IN   THK   IMVfcRSITV   OK    wi'K/BrKi, 


KDrrKi).  \vi  111  AnniTioNs.  bv 
J.  PLAYFAIR  McMURRICH,  A.M.,  Ph.D. 

PROKKSSOR    Ol-   ANATO:\1V    IN    THK    INULKSIIV   oj     Ml.  Hit. AN 


VOLUME  I 
BONES,  LIGAMENTS,  JOINTS,  AND  MUSCLES 


IVith  320  Illustrations,   Mostly  in  Colors 


I'll! I   Mil  I  nil  \     \N-|i    1  .i\p.  iv 

W.    B.    SAUNDERS    COMPANY 
1906 


gp,^ 


Co[>yright,  i()o6.  by  W.  B.  Saunders  Company 


M.     m       SAUNOCMS     CO 

^M  I  L  AO  e  L  P>H  l< 


m^m/mR^ 


EDITOR'S  PREFACE. 


There  can  be  no  question  as  to  the  value  of  a  gwxl  Atlas  of  Anatomy  as  an  aid  to 
the  acquisition  and  retention  of  correct  ideas  regarding  the  structure  of  the  human  hodv  and 
the  relations  of  its  various  parts.  Anatomy,  at  i.-ast  the  descrii)tive  ])art  of  i;,  is  k-arned  onl- 
when  one  can  call  up  a  mental  picture  of  the  part  in  ([uestion,  and  volumes  of  description  wih 
do  less  to  furnish  a  correct  picture  than  will  a  single  dissection  or  the  inspection  of  an  accurate 
illustration.  This  is  especially  ;rue  as  regards  relational  anatomy,  and  without  an  accurate 
know'ofjgc  of  the  relations  of  parts  the  student  or  practitioner  will  find  hims.lf  sadlv  at  sea  in 
his  a^  plication  of  Anatomy  to  diagnosis  and  treatment. 

To  both  the  student  and  the  i)ractitioncr,  therefore,  a  good  Atlas  must  prove  a  great  boo- 
to  the  one  in  enabling  him  to  imjjress  upon  his  mind  wliat  he  has  seen  in  the  laboratorv,  without 
recourse  to  the  pernicious  "qui/.compend,"  which  is  but  a  Tantalus  ,  up,  to  the  other  in 
recalling  the  mental  image  more  or  less  blurred  bytim( ,  The  !)resent  Atlas,  with  its  wealth  of 
accurate  illustrations  and  its  thorough  though  concise  desc,  :ptive  text,  is  presented  to  Knglish- 
speaking  students  and  practitioners  in  the  full  confidence  that  it  vvill  prove  of  the  greatest  value 
to  them. 

The  work  of  the  Editor  in  adaj)tin..,  the  Atlas  for  English  readers  has  largely  been  conlined 
to  changes  in  t'-e  omendature  and  :n  the  airangement  of  the  text.  In  the  (.riginal  (Jerman 
edition  the  text  and  Atlas  were  separate  \.)lumes,  the  Atlas  pro;  er  being  i)rovide(l  with  a 
descriptive  epitome  of  the  >  irts  re.<resented  in  the  various  figures.  It  has  siemed  1k>i,  both  to 
the  publisher  and  to  the  ixlitor  of  the  pr-sent  edition,  to  unite  the  text  and  Atlas  in  a  com- 
mon volume,  much  repetition  being  thereby  avoided  and  the  usult  being  still  a  volume  of  con- 
venient size.     The  translation  of  the  German  text  ha<  been  done  l;y  Dr.  \V.  Hersev  Thomas. 

As  to  the  nomenclature  emi)loyed,  it  is  es.sent.ally  that  projxjsed  by  the  Hasel  Committee 
on  Ana'omical  Nomenclature,  the  tenns  being,  h()we\er,  for  the  most  jiart  .Xnglici/.ed.  In  the 
section  on  Myology  thi'  Latin  terms  have  been  retained  throughout,  since  usage  has  already 
made  many  of  them  familiar  in  their  da.ssical  form  and  it  seemed  i)referable,  for  uniformity's 
sake,  to  use  that  form  for  all.  A  fe>v  terms  may  be  found  sor  ewl.at  unfamiliar  \n  luiglish 
speaking  students  of  anatomy,  and  when  these  are  used  the  more  familiar  term  lias  "been 
added  in  parentheses.  The  adoption  of  a  uniform  code  of  nomenclature  is  of  such  great  im- 
portance that  the  slight  inconvenience  which  the  i)resent  generation  may  exjjerience  in  the 
temporary  use  of  a  double  set  of  names  for  a  few  structures  will  be  more  tlian  counterbalanced 
by  the  advantages  which  a  universal  terminology  will  eventually  olTer. 

TiiE  Editor. 
University  of  Michigan,  April  tn,  iyo6. 


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AUTHOR'S  PRbFACE. 


When  I  was  invited  by  the  publishers  to  prejiare  an  atlas  of  descriptive  anatomy  at  a  time 
when  f^'ood  atlases  were  in  abundance  and  the  wants  of  the  jjrecedinj;  di>ennium  had  been 
largely  su|)plied,  I  did  not  accej)!  without  due  retlection  as  to  the  demand  for  such  a  work.  I 
believed  that  this  Jemand  could  be  1  t  tested  by  hu  -g  -^fudents  use  the  existing  atlases  in 
their  dissections.  This  test  demonstrate!,  not  only  t  ossible  ])oi)u'-irity  of  an  approi)riate 
work,  but  in  many  respects  em[)hasi/.ed  the  i.icessity  prei)aring  an  atlas  which  would  be 
handy,  practical,  not  too  comjirehensiv.  nnn-'i-d  with  illustrations  true  to  nature,  and 
specially  adapted  for  the  use  of  medical  stude-.'s  in  the  dissecting  room. 

My  first  thought,  conse(|uen  ^  vas  to  pn  •.•  e  an  atlas  which  would  sui)i)iy  the  ])ractiial 
wants  of  b<>th  the  student  and  the  .  ,  sician.  Jt  .s  not  an  atlas  fur  the  finished  anatomist.  The 
admirable  a..as  of  Toldt  contains  a  vast  number  of  well-chosen  illustrations,  but  it  is  so  com 
prehensive  that  it  is  difikult  for  the  student  to  pick  out  what  he  actually  needs,  and,  owing  to 
its  high  price  and  the  fact  that  many  of  its  illustrations  are  not  true  to  nature,  it  has  not  met 
with  great  favor  from  the  student  body.  In  the  present  atlas  ilie  aiir.  lias  been  to  limit  tiie 
material  to  what  is  absolutely  necessary. 

The  first  volume  has  been  comjjiled  as  an  atlas  esi)ecially  adapted  for  use  during  dissection, 
and  the  illustrations  have  consequently  been  arranged  to  conform  to  the  usual  miliiods  of 
instruction  in  anatomy.  The  fundamental  princii)le  of  the  work  lias  i)een  to  avoid  any  unusual 
presentation  of  the  subject  which  would  make  the  recognition  of  well  known  relations  more 
dilVicult  for  the  beginner. 

To  die  best  of  my  knr.wledge  this  is  the  first  anatomical  atlas  in  wide  h  muhicolor  lithograiihy 
has  been  employed.  .Mmost  the  entire  myology  has  been  illustrated  in  this  manner;  of  the 
thirty-four  plates  in  this  volume,  thirty  were  made  by  this  method  and  the  remaining  four  by 
the  so-called  three  (four)  color  process.  The  other  illustrations  wee  made  by  the  so-called 
half-tone  method,  the  complete  adajitability  of  which  is  alumdantly  demonstrated  by  the  ])!( - 
tures.  .\dditional  explanatory  figures  and  diagrams  ha\e  been  rei)roduced  by  simi)le  line- 
etching.  \()  woodcuts  have  been  emjiloyed,  since  the  failure  of  the  latter  method  to  produce 
illustrations  true  to  life  has  been  distinctly  sh  )\vn  by  several  of  the  newer  anatomical  atlases. 
It  leaves  entirely  too  much  to  the  discretion  of  the  wood-engraver,  whereas  the  photomechanical 
method  of  reproduction  depends  entirely  upoi_  the  impression  made  upon  the  photograjihic 
plate  by  the  original  drawing.* 

*  It  has  bee  -  <l;iimc(l  for  the  wvKxlrut  that  many  d.-siKna''  'is  may  !«■  rut  in  lli.  matrix,  so  ihal  r.firrm c  lines 
arc  not  necessary.  To  my  mind,  this  ndvantafri'  is  not  of  mu(  h  val..i-,  since  it  is  (|uite  a  limited  one.  I.iihographv  allows 
of  a  much  freer  sul)sequent  addition  of  Ih.-  desinnations  to  whatever  extent  they  m.iy  seem  d.-^irahle,  and  when  sm::!! 
they  are  not  so  illegil)le  as  they  fref|uently  are  in  the  wcKKlriil.  Sinie  it  is  undoubtedly  true  that  a  large  number  ..f 
reference  lines  are  inelegant  and  confusing,  they  have  Ix'cn  made  in  as  few  instances  as  possible,  and  where  many  dcsigna- 

'3 


H 


author's  preface. 


In  order  to  insure  the  accuracy  of  the  illustrations,  all  of  the  preparations  were  photoRraphed 
and  the  photograph  was  made  exactly  the  same  size  as  the  intended  illustration,  lenses  of  the 
longest  possible  focal  length  being  .mployed  to  avoid  perspective  distortion  *  In  the  great 
majority  of  the  illustrations  i)hotographs  were  employed  as  the  basis  of  the  drawings-  Figs 
167  to  171  are  direct  reproductions  of  photographs,  and  Figs.  178  and  181  were  made  from 
photographs  which  ha<l  been  touched  up.  Only  a  few  illustrations  are  diagrammatic  and  in 
such  instances  it  has  been  so  stated  in  the  titles. 

The  illustrations  pDduced  by  the  half-tone  method  have  been  made  much  clearer  bv  the 
use  of  a  number  of  colors.  A  buff  color  has  been  employed  for  the  bones  in  the  pictures  of  the 
joints  and  of  the  muscles,  and  ^arious  colors  have  been  used  for  the  different  Ix.nes  of  the  skull 
and  in  the  topographic  views  of  the  cranium.f  No  illustration  has  been  omitte.l  which  would 
make  the  relations  of  the  parts  more  readily  understood.  Microscopic  and  topographic  anatomy 
have  been  disregarded  to  a  certain  extent,  although  enough  has  been  given  to  serve  as  an  outline 
for  the  subsequent  volumes,  which  will  be  more  topogra,,hic  than  descriptive  in  character.  The 
i)arts  have  been  designated  according  to  the  Basel  nomenclature. 

The  original  drawings  for  this  Atlas  were  executed  by  .Messrs.  K.  Hajek  and  A.  Schmitson.t 
The  former  gentleman,  who  will  also  furnish  the  illustrations  for  the  subsequent  volumes,  has 
performed  his  diflicult  task  with  such  special  aptitude  and  cleverness  that  the  remaining  volumes 
promise  to  be  even  better  an.l  to  exhibit  still  greater  uniformitv  in  the  metho,l  of  pnHiuction. 

A  number  of  the  specimens  from  which  the  illustrations  were  made  are  in  the  collec  tion  of 
he  Anatomical  Institute  (Wur.burg),  and  I  take  this  occasion  to  express  mv  special  thanks 
to  Profess<.r  btohr  for  his  permission  to  employ  them  in  this  work.  The  majoritv  of  the  joint 
preparations  all  of  the  muscle  dissections  and  some  of  the  iK.nes,  1  have  mvself'prepare.i  for 
the  Atlas.  In  addition  to  tlie  photographed  specimens,  other  .lisseclions  have  been  made  and 
compared,  so  that  every  illustration  in  the  book  has  an  individual  character,  with  the  exception 
that  marked  anomalies  have  been  corrected.  The  muscles  have  been  given  a  bright  red  <  ..lor 
such  as  they  exhibit  in  a  fresh  body  after  they  have  been  exposed  for  a  short  time,  although 
less  intense  tones  have  been  selecte<!  than  those  of  the  natural  mu.scular  and  fattv  tissues 

The  i.ubhshers  have  .spared  nothing  to  make  the  illustrations  excel  those  ofall  other  works 
in  character  and  to  equal  if  not  excee.l  those  of  the  majority  in  number,  in  spite  of  this,  how- 
ever, the  prite  of  the  work  is  much  lower  than  that  of  most  other  atlases. 

Tin;  AiTnoR, 


tions  were  necessar,  ,h.y  have  Invn  .lis.r.l.u.e.l  over  several  h.ure..     I„  some  ins.anees  e,plana,„rv  .„„|in.  ,„  hin«.  h.ve 

^:::::i  i:;i^;r""-  ■"■^'""'-^ '-"-' ''-- " '''^"-"•-  -'-^  -"■  '"-^. -  >■ '■■-"  --'^; 

*  In  a  few  eases  in  win,  1,  |,er.,,eetive  .listnnion  was  feared  even  when  len,es  of  the  lonR-st  f,„  al   l.nRths  were  en- 
£:;!:,;"■■  ''"'■'  •  "^"  '•^"-'-^^■>'^'" -half  .he  si.e  of  ,he  ..esirH  ilh.s.ra.i ,n.l  ,he  ,„!„., ,,   .  ^^.^J^LZy 

in  h,  J.;;;:z::,;t ::;::;::' "- '""-  """•■  ■■-  -'--  -^ "-■"•"  ••^'  •"•■  »-"■■  - ^  < ^a,,,,,,, .  -  he  ,„ ,.„e 

t   AtxiUt   ten   uf    Ihl-    i||n»lrat!..>r!-.    •••.    !!;;■     •!!::;   ■^,:,- 

sulMijuenlly  eomplet'd  liv  Mr.  Ilajek 


rit-ti  r;y  \\  .  Fn  ytag,  .ii,iv»iNn  iiia.stei  in  the  I  niversily,  and 


CONTENTS 


Ifitroduction 17 

Osteology I,, 

Gexkrai.  ( )sTi:()i.or,v uj 

Special  Ostkoi.ocv 22 

The  Skeleton  of  the  Tkink 22 

The  Xcrtcbrul  Column 22 

The  Trui'  \'crtt'lir;c 22 

Till'  C\rvi\ al  \iTti'l)r:i' j ^ 

The  Thiiraiit  Nertehnr 26 

The  Lumhar  \erteljra- 27 

The  False  \'ertel)r:e 2S 

The  Sacrum 2S 

Ihe  ('onyx ^q 

The  X'erteliral  ("oluniii  as  a  \\  iKile ;o 

The    Develoiimeiit    of   the   Verlehral   Col 

umn .  I 

The  kihs [\\[  ,2 

The  Steriuim -^ 

The   Thora  \ .  ^ 

Tile  Develo|iment  of  tin-  Rilis  ami  of  tne 

Sternum .^ 

Variations  in  the  Skeleton  of  the  Trunk '^5 

The  Skeleton  t>F' THE  Hi; \i) ^f, 

The  Anterior  Aspect  of  the  Si-  nil \h 

The  Lateral  As|)ect  of  the  Skull ,7 

'I'he   i:\teri\al  Surface  of  tin    Uase  of  the 

Skull ,,, 

The   Internal  Surface  of  the   iia^e  of  the 

Skull ^, 

The  Superior  Aspei  t  of  the  Skull 44 

The  Inner  Aspect  of  the  Cranial  Vault  or 

Calvaria 44 

The  Hones  of  the  Skull 44 

The  Craniiil  Hones 4r 

The  ( )n  ipital  Hone 4^ 

The  Sphenoiii  Hone 4- 

The  Temporal  Hone ^i 

The  I'ariet.il  Hone i;,, 

The  Frontal  Hone ^ 

The  Fthnioirj   Horif t.  .    | 

The  Inferior  Turiiinateil  Hone f)4 

The  Lachrymal  Hone 64 


The  Skeleton  01  the  Head  (Cnnliiiiinl)        p,,,. 

The  Nasal  Hone (15 

The  \"onier 6:; 

'The  Maxilla 60 

The  Talate  Hone (xj 

The  Zxuoniatic  lione 70 

The  \ian<lihle 7, 

'The  Hyoid  IJone 7^; 

'The  ( )rliital  Cavities 7"^ 

'The  Nasal  Cavity 76 

'The   Roof  of  the  Oral  Cavitv,  the   Hani 

I'^.late -. 78 

'The  I'ter\!;opalatine  I'ossa 78 

The  Infratemporal  l''ossa 79 

'The  Sutures  of  tlie  Skull 70 

'The  Skull  of  the  Neu  horn 81 

'The  Skei  ETON  or  hie  Iatki  mitii  s 82 

The  Skeleton  (IE  thi    Cimm  r  i;\rKi\in\..  8^ 

'The  Shoulder  (iinlic 8^ 

'The  Scajuila 8^ 

'The  Clavic  !<■ 85 

The  Humerus 85 

'The  rina 87 

The  Hi<lius 88 

'The  Hones  of  the  Hand 8() 

'The  Carpal  Hones 8() 

'The  MetiUarpal  Hones iji 

'The  Hones  of  the  I'ini;ers ()2 

'The  Sesamoid  Hones  of  the  Haml <)2 

The  Skeleton  of  the  Hand  as  a  Whole ()2 

I'm  Ski  I  troN  or  Tilt  l.oui  k  lAikiMin  . . .  qt, 

'The  I'ehii  (iirdle ij^ 

'The  Innominate  Hone (j^ 

'The  Femur ((7 

'The  Patella ,,,, 

'The   Tihia ()() 

'I  he  I'iliula 101 

'The  Hones  of  llu   FiMit 101 

1  he  'Tarsal  Hones 102 

'I'he  'Talus 102 

Thv  CilrHHHi- ic;;; 

Thi'  Navii  ular  Hone 10? 

'The  ("ulioid  Hone 104 


i6 


CONTENTS 


i 


PAGE 

The  Skeleton  of  the  Lower  Extremity 

The  Cuneiform  Bones 104 

The  Five  Metatarsal  Bones 105 

The  Bones  of  the  Toes 105 

The  Sesamoid  Bones  of  the  Foot 106 

The  Skeleton  of  the  Foot  as  a  Whole 106 

Syndesmology ^°1 

General  Syndesmolugv 107 

Synarthroses 107 

Diarthroses  108 

Special  Syndesmoi,o(;y 1 10 

Joints  and  Lioaments  of  the  Vertebral 

CoLiMN 1 10 

The  Connections  of  the  Vertebral  Bwiies  .110 

The  Intervertebral  Articulations 1 1 1 

The  Ligaments  of  the  Vertebral  Column. .  .111 
The  Articulations  of  Sacrum  and  Coccyx.  .113 
The  .Articulation  of  the  l'i)()er  Two  Cer- 
vical X'ertebra'  with  Kach  Other  and 

with  the  Occiput 1 13 

The  .\rticulations  of  the  Ribs  with  the  \er- 
tebral  Column  and  with  the  Sternum. .  1 16 

The  .Artici-lation's  and  Ligaments  of  the 

Head 117 

The  Temporomandibular  .Articulation 118 

The  Inde|)endent  Lii;aments  of  the  Head.  118 
The  Lipaments  of  the  Hyoid  Bone 1  iq 

The  Joints  and  Ligaments  of  the  Upper 

Kxtrkmity iig 

The  SterniH  lavicular  .Articulation i  k) 

The  .Acroniiiiclavicular  .Articulation 1  20 

The  Lipaments  of  the  Sca|)ula 1 20 

The  Sill lulder- joint '21 

The  Llbow-jiiinl 122 

The  I)i>tal  Radio  I'Inar  Joint  .md  the  In- 
terosseous Membrane 1  23 

The  Joints  and  Ligaments  of  thi.  Hand...  124 

The  Joint>  of  the  Carjius 124 

The  Carpal  Lipaments 1  2(1 

The  Unper  joints 127 

TirK  Joints  ani>  Ligaments  of  the  I'kiak 

(liHKLF 128 

The  I'ehic   Lipamei.tv.  Synarthroses  and 

Diarthroses 128 

The  liidepen<lent  Lipameiils  of  the  I'elvi:   1  21) 

Tlie  I'llvis  as  a  Whole 130 

The  Hip- joint 131 

The  Knee- joint 133 

The  Articulations  of  the  Tibia  and  Fibula  .  13(1 


PACE 

The  Joints  and  Ligaments  of  the  Foot  ...  137 

The  Joints  of  the  '^oot 137 

The  Ligaments  of  the  Tarsus 139 

Myology '42 

(jEneral  Myology ^4^ 

Special  Myology i44 

The  MrscLF.s  of  th  .  Trunk 144 

The  .Muscles  of  the  Back 144 

The  Short  Muscles  of  the  Xeck 155 

The  Fasci;e  of  the  Back 1 56 

The  .Abdominal  Muscles 157 

The  .Abdominal  Fa.scia- 163 

The  Diaphrapm 164 

The  Thoracic  Muscles 166 

The  Pectoral  Fascia- 170 

The  .Muscles  of  the  Neck r  7 1 

The  Prevertebral  Cervical  Muscles 1 76 

The  Fascia  of  the  Neck 177 

The  MfscLES  of  the  Head 177 

The  Musdes  of  the  Fai  e  and  of  the  Scalp   .178 
The  Fascia  of  the  Head 184 

The  Mis(  les  of  the  C     er  Fxtremity  — 185 

The  Muscles  of  the      oulder 186 

The  Mu>cles  of  the  I  ;ii)er  .Arm 188 

The  Muscles  of  the  1  urearm i<)i 

j  The  Muscles  of  the  Hai.d ig8 

I  The  Muscles  of  the  Thenar  l.minence iqi) 

'  The  Muscles  of  the  Hy|>othenar  Fminence  200 

The  Inlerossei  and  Lumbricales 200 

The  Relalinnsof  the  Fxtensor  Tendonsand 
their  Sheaths  beneath  the  Dorsal  Car- 
pal Lipamenls 203 

The  i;\teM>cir  Tendons  of  the  Finpers 204 

The  TeiKJoiis  and  Synovial  Shcatlis  of  the 

Flexor  Teiiilons  in  the  Palm 205 

The  ['as(ia' of  the  Cppcr  Fxtremity 207 

The  Most  Important  Bursa'  of  llir  rp]HT 
JAlremitv 20H 

The  Mcsi  I  fs  of  the  I.owtR  Fxtremity  —  2og 

The  Musi  les  >'(  the  Hip 210 

The  Muscles  of  the  'Fhiph 214 

The  Muscles  of  the  Lep 2l() 

The  Mus.  l.s  i.f  ihc  F<K.l 224 

The  Sviii'i  1.1 1  Sheaths  of  the  FimiI 22q 

The  I'asiia  of  the  Lower  Fxtremity 231 

The  Most  Imi>ortant  Bursa  of  the  I^)wcr 
F--:ir!mity =3,1 

Index 2^7 


rAOE 

-•137 
-■137 
--I39 

..142 

..142 

..144 

--I44 
..144 

•-■55 

..156 

•  -I57 
..163 

.  .164 

..166 
..170 
..171 
...76 
..177 


.  .  .  2CK) 

. .  .210 

...214 

...210 

...224 

. . .22Q 

.  .  .  2?  I 

WIT 

•  ■  '  -.1.1 

...H7 


ATLAS   AND   TEXT-BOOK 


HUMAN    ANATOMY. 


INTRODUCTION. 

Human  anatomy  treats  of  the  structure  of  the  human  bo<Iv,  in  contrast  to  physiology-, 
which  treats  of  function,  ami  it  is  usually  sulxiivi.le,!  into  general  anatonn  an<!  special  anafm,; . 
General  anatomy  is  practically  synonvmous  with  histologv,  an.l  treats  of  the  structure  of  the 
comixment  i)arts  of  the  both  . 

Special  apntomy  is  usually  termed  .iescriptive  or  systematic  anatomx ,  since  it  consists  of 
the  simple  description  of  the  dilTerent  parts  an.l  systems  of  the  My.  It' is  conse(,uenlly  com- 
lK,se,l  of  a  number  of  sulxliyisions:  OsteoloRy,  treating  of  the  U.nes;  Syn.ie.smology,  t'reatin- 
of  the  jomts  and  ligaments;  Myology,  treating  of  the  muscl.s;  Splanchnology,  treating  of  the 
yi.scera;  Angu.logy,  treating  of  the  yessels;  Neurology,  treating  of  the  neryous  system;  an,!  of 
the  description  of  the  organs  of  S])ecial  sense  and  of  the  skin. 

Descriptiye  anatomy,  considere.l  from  the  special  standpoint  of  die  mutual  relations  of  the 
in.liyidual  parts,  ,s  termed  topograpHi,  anatomy,  and  that  branch  of  anatomy  -.yhi.h  ha.  to 
do  with  the  deyelopment  of  the  Ixxly  is  designate,!  Kmbnologv . 

To  in.licate  the  rela!ion>  .,f  the  different  parts  of  the  IkkIn  to  ,ach  other  or  to  the  lK,dy  in 
general,  certani  technical  .  vpro.ions  are  employe.!.  In  des.  ril.inu'  ihe  position  of  a  structure 
a  i>  always  to  be  asM.me.l  that  ilu'  lK.!y  is  in  the  ere,  t  p,.>t,.re.  Tl,..  m,.,lian  plane  .lixi-les  tlie 
b..ly  into  two  alnu,st  similar  habes*  sin.e  man,  like  th,.  nuijorilN  of  animals,  i>  bilaterally 
.symmelruv.l.  .\ny  plane  of  th,'  lunly  u  hi,  I,  is  parallel  t,.  th,-  mclian  plane  is  t.-rnu,!  w;^.,//,,/ 
(from  tlu'  sagmal  sutur,.,  see  page  7,,,;  di,.se  whi,  h  ,>ass  thn.u.J,  the  Uxly  hon/.onialh  are 
terme,!  Iwrn.n,,.,/  or  Iransr.rs.,  while  v.rnV.d  planes  at  right  angles  to  th..  m,dian  plan,-  are 
kn..wn  as  /.„«/<//  phmes,  sin.,-  th..y  are  pandl.l  to  the  for.hea,!.  If  a  part  is  siu.ate,!  n.arer 
10  the  mcban  plane,  11  ks  .lesignalnl  hil,rn,il  ,.r  mnfi.il;  while  if  it  is  m,.r,.  remol,.  it  is  sai.l  to 
Ik.  ..y/,  W  or  h,/rr,.l.  The  ,!ir..,  tion  toward  ihv  n.clian  pla  i,  spok.n  ..1  as  i,n.„nl  and  the 
<)|)lM)sile  .lirecti.in  as  imlwani. 

Th,-  wonis  niumal  an,l  .xt,r,u,l  ar..  also  ..mpioye.l  in  nf,.r..n,.-  t,.  l!,.-  ..niti.s  of  th.-  1h.,1v 

•  \ltim„«h  ,l„.  I.il.a.ral  sy,„m,trv  U  no,  ,o,„|,l,„   in  ,l„  ,„lull  IkhIv,  i,  i,  ,.rf.U  .luonfi  .ml.ryoni,  lit,-. 


i8 


INTRODUCTION. 


or  to  the  inner  or  outer  surface  '.''  i  portion  of  the  body;  in  this  connection  it  is  frequently  better 
to  substitute  the  word  superficial  for  external,  and  deep  for  internal.  Above  and  below,  like 
all  other  designations,  refer  to  the  irect  i>osition  of  the  body,  and  this  direction  may  be  frequently 
better  indicated  by  the  terms  cranial  and  caudal.  In  front  and  behind  refer  to  the  anterior 
and  posterior  surface  of  the  body,  but  this  relation  may  be  more  accurately  expressed  by  ventral 
anrl  aorsal. 

Special  additional  designations  arc  to  a  certain  extent  necessary  for  the  extremities.  In 
this  connection,  proximal  means  nearer  to  the  trunk  and  distal  more  remote.  In  the  forearm 
it  is  preferable  to  use  the  words  radial  and  ulnar  instead  of  outer  and  inner,  since  during  prona- 
tion (see  page  123)  the  inner  side  is  directed  outward  and  vice  versa;  and  since  the  pahn  cf 
the  hand  and  the  sole  ni  the  foot  are  designated  respectively  as  the  volar  and  plantar  surfaces, 
the  words  volar  and  plantar  are  used  to  indicate  the  position  of  parts  situated  upon  the  corre- 
sponding surfaces. 


OSTEOLOGY. 


GENERAL  OSTEOLOGY. 

The  greater  portion  of  the  skeleton  of  the  human  body  is  composed  of  bones,  the  remainder 
consisting  of  cartilages,  and  since  the  lx)nes  consist  largely  of  lime  siilts  they  are  miirh  lirmer 
than  tl-  •  cartilages,  which,  though  harfl,  arc  nevertheless  flexible.  The  i)arts  of  the  skeleton 
are  either  j .aired  or  single,  the  latter  being  in  the  minority. 

The  bones  of  the  human  body  van,-  greatly  in  their  form,  shape,  and  size.  The  largest 
bone  is  the  thigh  bo,>c  or  femur;  the  smallesi  are  the  sesiunoid  bones  of  the  harJ  and  the  auditon,- 
ossicles.  According  to  form,  we  usually  disiinguish  between  Inn  or  tiibii/ar  hon<s,  broad  or 
fat  bones,  and  short  hones,  while  bones  ])ossessing  air-confdning  cavities  are  also  calkxl  />«<■(/- 
tnatk  l.ims. 

The  long  brrics  have  in  general  a  cylindrical  shajjc  and  are  found  only  in  the  extremities. 
With  few  exceptions,  they  consist  df  a  middle  iK)rtion  or  shajl  dliapliysis)  and  of  two  ends  or 
cxtranitics  {cpip/iyscs*).     The  shaft  contains  a  cavity,  the  nudullary  cavily,  w  is  filled  wilh 

bone-marrow,  and  it  is  on  this  account  th.U  these  ijones  are  also  termed  //(/'  ix)nes.  The 
bony  sub.-taneeof  their  shaft  surrounds  this  medullary  cavity  and,  on  account  of  \\.  firm  slnirture, 
is  know  1  as  the  compact  substance,  in  contradistinction  to  a  less  .knse  sjKingy  substance,  which 
consists  of  a  fine  network  and  forms  llie  greater  portion  of  tlie  extremities  of  the  lx)nes  with 
the  exception  of  a  ver>'  thin  outer  conipat  i  layer  of  c  )rliial  substance. 

Tile  long  i)ones  of  the  human  txxly  are  found  only  in  the  skeKton  of  the  extremilies.  They 
are  as  follows,  the  ckivicle,  the  humerus,  the  radius,  the  ulna,  the  five  nietaeaq)al  JHrnes,  the 
l>ones  of  the  fingers  and  toes,  the  femur,  the  tibia,  the  !".bu!a,  and  Uie  metatars;il  lx)nes.  Tiic 
ribs  are  classified  with  tlir  Hat  Ixmes. 

The  broad  nr  flat  bones  are  markedly  llattened  one  direction  rind  have  the  sliajje  of 
llat  or  curvid  pkiics.  Their  central  portion  ((insists  ot  spo-gy  l>one,  the  cortex  In  ing  fonued. 
ho\ever,  l)y  a  more  or  less  thick  kiyer  of  comjiact  corlieal  substance.  In  manv  iii^tauds  tl  cy 
are  i.r-vi.ied  with  well  markeJ  iinnesses.  In  the  tlat  Ixnies  of  the  skull  the  spongios;i  i>  kno\  n 
a>  the  (///)/,)(•,  while  the  la>ers  .if  compact  subs!  ukc  are  designated  as  the  outer  i'nd  inner  vitreou.- 
laMvN  The  llat  Ixiius  of  the  human  IhkIv  are:  the  sternun-,  the  scapula,  tlu  innoiiiiiiale  l«.nes, 
the  rii)s,  and  many  of  the  (  raniai  Ixmes. 

The  ■  lort  bones  have  an  irregular  fomi  and  ;  ■  one  ot  liuir  diameters  giialh  e\((((ls  the 
others.      ..ley  consist  almost  entirely  of  spongy  ti--ue,  their  e()mpa(  t  ((irti(al  laver  be  iiii,'  fre 


f!licn!!v  VI- 


thi-- 


Tht\  are  freijUeiit!\ 


ii: : 


♦  Tlic  'crnis  I  |ii|iluMs  am!  rxin  mil'i«  .in   rii.l.  as  a  rulf, 
I'xtrcmiiit-,  usually  mnlain  |Mirtiim^  uf  ilu-  ilia|>liv>JH  a-  we 

'9 


in  1,'i't'!!  '.:',  groiijjs,  as  in  liii  carpus  aini  i.nMi.-..      1  in- 

nuii^nidus,  siiHi-  llir  |Mir;ii.i,,  ,if  \\h-  Ikiiics  iI, -ii-ii.iif  il 


a^sLj.. 


._^JkijJ 


20 


ATLAS   AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 


most  important  short  bones  of  'he  human  body  arc:    the  true  vertebra?,  the  carpal  bones,  the 
tarsal  bones,  the  patella,  and  the  sesamoid  bones. 

In  addition  to  the  long,  flat,  and  short  bones  there  arc  a  number  whic.i  cannot  be  ciassiCcd 
in  any  of  the  three  cate<;ories.  These  are  designated  as  irregular  bones ;  as  a  rule,  thev  repre- 
sent transition  forms  between  the  broad  and  flat  bones,  as  in  the  cases  of  the  sacrum  and  of 
many  of  the  cn-.nial  bones.  Among  the  latter  there  are  also  some— for  e.\ami)lc,  the  temporal 
bone  and  the  occijjital  bone— which  in  a  portion  of  their  extent  are  typical  flat  hones,  while  in 
their  remaining  jjortions  they  would  be  regarded  as  belonging  to  the  group  of  the  short  or  irreg- 
ular bones. 

.AH  the  varieties  of  bones  may  possess  prominences  which  take  the  form  of  projections, 
ridges,  and  ])roce.«ses  of  the  most  viritd  shapes.  .-According  to  their  size  and  form,  they  are 
designated  as  tubercles,  tuberosities  (rough,  more  or  less  jironounced  projections),  spines,  crests 
(rough  lines  or  projecting  ridges),  processes,  condyles  (also  termed  condyloid  or  articular  processes), 
epieondylcs  (/.  c,  j)rojecli()ns  situated  alxivc  the  condyles),  and  outgrowths  {apophyses).  In 
a  similar  manner  many  bones  possess  excavations  {jovece  or  josser),  impressions,  grooves,  furrows 
{sulci),  notches  (incisurir),  perforations  {joramina),  slits  {hiatus),  and  canals.  The  enlarged 
rounded  ends,  particularly  of  the  long  bones,  are  frequently  called  heads,  while  the  constriction 
situated  beneath  tliem  is  known  as  the  neck.  All  bones  poss  ss  larger  or  smaller  foramina  for 
the  entrance  of  the  nourishing  l)lood-\  sscls;  these  are  known  as  the  nutrient  joramina,  and 
are  particularly  large  in  the  shafts  of  the  larger  long  bones,  where  ?hey  lead  into  a  nutrient  canal, 
which  extends  into  the  medullarv  cavity. 

Thi  hones  of  the  human  body  are  usually  studied  in  the  n.acerated  condition,  /.  e.,  after 
their  soft  j.art.-,  iia\e  been  removed  by  putrefaction.  The  bones  of  the  living  bo<ly  and  of  the 
dead  subject,  however,  consist  not  only  of  bony  substance,  but  also  of  a  series  of  soft  tissues, 
some  of  which  jjartly  resist  jiutreiaclion,  so  that  the  "entire  bone"  is  composed  of  the  following 
constituents:  (i)  The  actual  Iwn;- tissue;  (2)  the  jjeriosteum;  (3)  the  articular  cartilage;  (41 
the  hone  marrow;  and  (5)  the  nutrient  ves.sels  and  nerves. 

Th.'  mai.iMti-.l  liimc  n  priscms  nut  .,nly  lli>-  l«,m-ash,  ,'.  r.,  tlic  <alcium  salts  of  llio  iKinc,  but  also  lonlains  otlur 
orcatii,  (onslilucnts,  Tlu'  In.in-  Mil.slaiKi'  .(insists  ihrmi,  aliy  ..i  alinoM  tuo-thirrls  inorKanii ,  ami  of  a  litllt- miw  than 
ontthiril  orKanio  mali  rial;  tin-  latlir  is  hi.-lly  plalin  or  oss,  in,  an.l  ni.iy  ]h-  dfmonstratril  in  lh<-  furni  of  Ih.'  so-<alIicl 
Imni'-iartilaKf  by  .xtra.linK  tin-  (allium  .salts  with  a.  i.K.  Tl,,.  ii„,r(;anic  .onslitu.-nts  of  bom  an-,  (allium  larbonati- 
(aU.ut  85.5  |.ir  i.nl  i.ialiium  |ilios|,l,alr  (al«.ut  o  per  i  int.1,  i  ali  ivmi  lUiori.le  (alK)Ut  ,;.5  per  n  nt),  and  maRncsium 
|.n..s|ilialc  (about  1,7;  piriint.),  anil  may  b.  il.monslral.il  by  hialinKlhf  drivd  boni' to  incand.'S(  in,  c.  limh  llii- bone 
larlilaKi'  and  tin-  ,  al.  in.d  bom-  main  llic  original  sha|a'  01  tin-  bonr  from  whirh  Ihcy  were  obtained,  tliu  orRanii  and  llu- 
inor^anii   1  onstiiui  ills  bring  inlimalily  intirniin>;lii|. 


I  he  actual  bony  ti?  -le  apptaiN  in  two  ni(>(!ilications,  which  jiass  into  each  other,  how 

ever,  wi'huut  ileniaixat  he  conijiac  t  Mih>b(ine  and  the  >p.ingy  sul^laiuc.     The  former  lui> 

a  dense  and  ap|iarenli\     |Uiti'  iinil'orni  stmiliire,  while  the  spongy  suifsiance  conM.sls  of  a  line 

network  of  Iwrny  trabet  uhe,  whit  h  al  lirsl  sight  seem  to  be  without  delinile  arrangement. 

In   reaJilx,   howe\-er.  the  :in  liiioi  tnro  of  tli(.  cTu>n.r,    ^iilj^i. ,«,.,.  jo   i„.   .,,,  .,,, : r--!ir 

.  /  i'""r .:    '••'•■■'•■   11 ! t -    n  ;..;,,  1:1a . . 

Its  parts  are  arranged  in  siuli  a  manner  a>  to  pnxiiiie  a  tirm  and  resistent  structure  with  the 
greatest  po^bihle  sa\ing  in  weight,  and  a  careful  examination  of  its  trabecular  and  plates  will 


GENERAL   OSTEOLOOY.  21 

show  that  they  arc  placed  so  as  tc  lie  in  the  direction  of  the  greatest  pressure  or  muscular  trac- 
tion exerte:i  upon  the  bone,  and  cvcr>-  bone  or  part  of  a  lK)ne  formed  of  sp.  -v  substance  con- 
tains, consequently,  several  intersecting  systems  of  trabecule  which  cross  each  other  mostly  at 
right  angles  (Figs.  167  to  171). 

Almost  nowhere  in  the  Ixxly  do  we  fmd  Ixiny  tissue  uncovered,  as  it  is  enveloped  either 
by  articular  cartilage  or  by  periosteum.  Articular  cartilage  covers  the  ends  of  two  lx>nes  form- 
inn  a  joint,  a.s  in  the  extremities  of  most  of  the  long  bones;  the  remainder  of  the  lx)ne  is  envit-)ped 
by  f)eriosteum,  a  fibrous  connective-tissue  structure  van,-ing  thickness,  whiih  is  of  great  im- 
IX)rlance  for  the  nou-ishment,  growth,  and  regemiation  of  the  bone.  Articular  cartilage  i.; 
hard  but  elastic,  and  consists  of  the  so  called  hyaline  cartilage.  Its  thickness  varies  gnriK  in 
difTerent  bones,  Ix^ing  sometimes  only  the  fraction  of  a  millimeter  or  in  other  cases  amounting 
to  several  millimeters.  (I  )r  ihe  mo:v  minute  structure  of  tone,  jieriosteum,  articular  cartilage, 
and  lx)ne-mar-ow,  see  Solxuta's  "Histology,"  Saunders'  "Medical  Hand  Alhues.") 

The  bone-marrow  appears  in  two  varieties,  the  red  and  the  yellow,  TIu-  ycll„w  marrow 
is  really  fat  tissue,  and  is  found  in  the  medullar)-  cavity  of  the  long  Ijones  of  the  adult,  while 
in  young  individual-  these  spaces  are  Idled  by  red  marrow,  a  soft  vascuiar  structure,  whiih  is 
also  situated  in  the  liner  medullar,-  spaces  of  the  adult  Ix.ne  Ixtwetn  tin  sp.,ngv  trahecuke. 

The  vessels  nourishing  the  lx)ne  are  found  cliiell\  in  the  medullar-  cavit\  and  ].eri()sirum, 
but  they  also  occur  in  the  bony  tissue  itself.  The  nerves,  on  the  contrary^  are  found  princinallv 
in  the  periosteum,  the  bony  tissue  having  no  ner\es,  and  the  articular  cartilage  luither  nerves 
nor  vessels. 

In  certain  regions  of  the  hur.an  Ixxly,  ewn  in  the  a.lult  condition,  jxirdons  of  the  skeleton 
arc  formed  by  cartilage,  as  at  -he  anterior  extremitiis  oi'  ilij  ribs,  and  sin.e  lartilage  is  clastic 
and  flexible,  it  jjlays  quite  a  (V  rent  functional  role  from  dial  of  lx)ne.  These  canilages  are 
enveloped  by  a  connective  tiss,'.  covering,  the  p,ricli>mdriu»; 

Willi  rcfrnncc  to  tti.^  .i,v,-lopm.-nl  .,f  h„n,.,  |nv„  v^rioiirsuf  l«,n,.  furi.^mion  an-  r.TORnizal.I,..  ThrKr.-al  tnaj<,rity 
of  thr  Lotus  ar..  lai.l  down  l„  .artilap.  ai  a  <mam  sta,?>- .  f  f.tal  .iinloimi.  nt,  an.l  llu-s.-  l«,nrs,  whi,  h  arc  tint,  pr.for.tt.-.l 
in  .artilagr,  stan.l  in  contrast  with  those  «hi<h  an-  fornu.l  l,y  th,-  ,linrt  ossifi.ation  of  ,  onnc.  tiv  tivs,,,.,  the  s,,-,  .,l,,l 
itifmliraiious  iK.nrs,  .■.vampl.s  of  which  arc  to  !„•  foi„„l  in  ihc  majorilv  of  tlu-  Hal  .  ranial  Inincs  an.l  in  n,,,„v  of  ,h,.  fa,  iai 
bones.  (For  a  minute  dcMription  of  the  processes  of  o.sili,  alio..,  s,  ,■  SolK.tla'.  "  Ilistolo^-N .-  Saiin.lcrs-  ■■  Mdi.al  II  m.l 
Atlasi's.") 

During  the  transfornialion  .,f  the  ^artila^'in.uls  inlr,  the  iK.nv  skcl,  ion.  a  pro,  cs.  «hi,  I,  lie-in.  carlv  l,ui  pr,„,>,ls 
slowly  an.l  la.sts  very  long,  usuallv  nol  l.einn  completed  unlil  the  lw,niv  lifih  vcar,  ^-.called  .emers  .,f  ,„si,„  „ion 
apiH.ar  in  the  cartilaginous  portion^  of  ihc  skel.ion  Tlu-c  , enter,  nuv  U-  si„g|,.  ,.h,.rt  l«,ne  ,  or,  as  is  uM.allv  the 
ta.se,  multiple,  and  .sometimes  they  .u,ir  in  relativch  large  nmnlHr.  an,l  are  s,,me«hal  irn-gulariv  arranged  (a-  in  the 
sternum).  I  sually,  however,  particul.irly  in  the  long  !».»,■.  of  the  estremi'u  ,  the  ,  enter  for  the  fulur.'  shaft  of  the  U.ne 
the  diaphvsial  center,  appears  firs,,  while  the  en.ls  or  epiphyses  s,i||  r.ma.n  artilaginou.,  an,l  each  epiphvsis  laler  ,le. 
veU.ps  at  least  one  ami  f^.,,uentl^  several  s.'parate  centers  of  ossil,,  ,,iion  (the  evcepiion-  .,re  giv,  n  npon  pag,'  y  ■>  whi,  h 
not  only  apiK-ar  at  a  much  later  peri,Kl  than  the  .liaphysial  enter.  Inn  long  after  hirlh  an  Mill  -,  parated  fn.n,  !h.  ,,n 
ler  for  the  .haphy-is  hy  a  layer  of  >  artilag,-.  This  is  term,,!  ihe  epiph^.ial  line  (syn,  lumdr.u.  .,>,/ I,ys.;.s),  and  ,1  linally 
disapfiears  and  the  Ixjiie  Injcomes  obsilitd  lliroughuut. 


..^Ai-  r»,«ipvv;f>i: 


'^*^. 


32 


ATLAS   AND   TEXT-BOOK   OF   HUMAN    ANATOMY. 


SPECIAL  OSTEOLOGY. 

The  human  skeleton  may  be  Ecpara'ed  into  three  chief  divisions:  (.\)  The  skeleton  of  the 
trunk;   (H)  the  skeleton  of  the  head;   (C)  the  skeleton  of  the  extremities. 

I-'rom  the  stan(ifM)int  of  embryology  and  t-voiution  the  skeleton  should  lie  divided  into:  (i)  The  axial  skeleton, 
»'.  c,  the  vertebral  eolunin  with  its  adnexa  and  the  greater  part  of  the  base-  of  the  skull;  {2)  the  appendicular  skeleton, 
/.  r.,  the  skeleton  of  the  extremities;  and  ( ^^)  the  membrane  and  viseeral  bones,  /'.  f.,  the  Hat  bones  of  the  rranial  vault 
and  the  facial  Ixmes,  and  those  portions  of  the  skeleton  which  re|)resent  the  visceral  or  branchial  skeleton  of  the  lower 
vertebrates. 

The  skeleton  of  the  trunk  is  formed  by  the  \ertebral  column  and  its  appendages  (the  ribs 
and  the  sternum),  the  skeleton  of  the  head  is  re])resented  by  the  skull,  and  the  skeleton  of  the 
extremities  is  further  sulxlivided  into  the  skeleton   )f  the  uj)per  and  that  of  the  lower  extremity. 

The  Skeleton  of  the  Trunk. 

The  principal  portion  of  the  skeleton  of  the  trunk  is  the  vertebral  column,  which  is  com- 
posed of  a  series  of  ])arts,  the  verlebrcr.  A  ty])ical  vertebra  consists  of  a  body  and  of  arches, 
these  latter  being  sulxlivided  into  a  posterior  or  dorsal  and  an  anterior  or  ventral  arch.  The 
posterior  or  dorsal  arches  surround  the  spinal  cord,  while  the  anterior  or  ventral  arches,  in  the 
form  of  the  ribs,  are  well  de\eloped  only  in  the  thoracic  portion  of  the  vertebral  column  and 
are  rudimentan,-  in  the  remaining  vertebras  they  surround  the  vegetative  cylinder  of  the  body, 
the  intestine.  While  the  dorsaJ  arches  are  firmly  united  with  the  bodies  of  the  vertebra-,  the 
ribs  are  jjaircd  bony  arches  articulating  with  the  thoracic  vertebne  behind  and  anteriorly  with 
a  sj)ecial  bone,  the  brcast-lx)ne  or  sternum. 

The  entire  series  of  the  vertebra;  form  the  s])ine  or  vertebral  column,  and  the  thoracic  ver- 
tebra- with  the  ribs  and  the  sternum  form  the  thorax.  The  skeleton  of  the  trunk  consequently 
consists  of  the  vertebral  column  together  with  the  thorax. 


THE  VERTEBRAL  COLUMN. 
The  TRUE  VERTEBRiE. 

In  the  vertebral  column  two  main  subdivisions  may  be  recogni/.ed.  One  subdivision  is 
formed  by  the  true  vertebrcr,  the  other  bv  the  jalse  vertebra-,  the  former  being  separate  bones 
connected  by  ligaments  and  joints,  while  the  latter  are  united  by  bon\  tissue  to  form  larger 
hones.  The  entire  human  spinal  column  consists  of  thirty-two  to  thirty-five  vertebra-;  of  these, 
twenty-four  are  true  vertebra-  and  eight  to  eleven  are  false  vertebra.-.  The  true  vertebra;  may 
be  separated  into  three  sulxlivisions:  (i)  The  cervical  verttbra-;  (2)  the  thoracic  or  dorsal 
vertebra-;  and  (^  the  lumbar  vertebra-.  There  are  seven  cervical,  twelve  thoracic,  and  five 
lumbar  veri.  Ijra-. 

.■\  typi(al  vertebra  is  comijosed  of:  (i)  The  bod;  ;  (3)  the  vertebral  arch;  and  f_^)  a  num- 
ber of  ])rocesses. 


THE  VERTEBRAL   COLUMN. 


23 


The  body  (Figs,  i  and  2)  is  composed  of  spong\-  substance  enclosed  by  a  thin  layer  of  cor- 
tical compact  bone.  It  presents  a  superior  and  an  inferior  plane  or  curved  surface,  an  anterior 
surface  markedly  convex  from  side  to  side  and  slif,'htly  concave  from  above  downward,  and 
a  posterior  surface  which  is  concave  in  Ixjth  directions.  The  posterior  surface  usuallv  presents 
one  or  more  larn;e  nutrient  foramina  and,  with  the  vertebral  arch,  completes  the  enclosure  of 
the  spinal  foramen  (joramen  vertebralr).  The  arch  consists  of  somewhat  I'lrmer  tissue  than 
the  body  and  forms  from  a  half  to  three-(|uartcrs  of  a  circle.  The  ]>ortion  continuous  with 
the  body  on  each  side  is  known  as  the  pedicle  or  root  (radix  arcus  irrltbrtr)  (Vv^.  i),  antl  presci  '~ 
a  notch  upon  both  its  ujjper  and  its  lower  surface  {the  superior  and  '.njcrior  irrtcbral  iwlclns) 
(Fig.  2),  the  notches  of  contiguous  vcrtebne  (the  inferior  notch  of  the  upper  vertebra  and  the 
superior  one  of  the  lower  vertebra)  together  forming  an  intervertebral  foramen  whi(  h  commiini- 


transverse  process.  /, 


proceai. 


spinous  process 


,.     .        suptnon/ertebral  notch 
superior  arlicular  r\:  rv 


process 
SUpenordimi  facet 
forhcadofnp\   < 


matiersc  jjroeas 


facet  for 
luhercleof 
rib 


h  'Or  demi  facet  Inferior  Inferu.  ^ 
fo,  .eadofrib  mlebral  articular 
'  '  notch     firoeess 


A  vcrtcljra  seen  from  above. 


Flo.  3. — .A  vcrtilr    >oen  from  the  siili- 


cates  with  the  spinal  canal.    The  superior  intervertebral  notch  is  usually  the  shallower;    the 
inferior  one  the  dce[)er. 

The  processes  of  the  vertebra-  consist  of  the  articular  jirocesscs  (Fig.  2),  for  the  ])urpose 
of  articulation  with  neighboring  vertebra-,  and  the  spinous  (Pig.  2)  and  transverse  processes 
(Fig.  i),  which  serve  as  ])oints  of  attachment  for  the  mu.scles.  Even,-  t\  ^  ''-al  vertebra  j)ossesses 
four  articular  processes,  two  superior  and  two  inferior,  and  these  bear  articular  surfaces  which 
are  correspondingly  named.  Of  the  remaining  jjrocesses,  the  sjjinous  process  is  single,  while 
the  transverse  j)rocesses  are  paired. 


THE  CERVICAL  VERTEBRE. 

Of  the  seven  cervical  vertebra-,  the  two  uppermost  ones,  the  first  or  atla^,  and  the  second 
or  axis  (epistropheus),  show  marked  deviations  from  tlu-  type.  They  are  also  known  as  "rota- 
tor\'"  vertebra;,  in  contradistinction  to  the  remaining  vertebra-  (tle.xion  vertebra-l. 

The  general  characters  of  the  cervical  vertebra-  (Figs.  4,  5,  and  6)  arc    \.s  follows;    The 


24 


ATLAS    AND   TEXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  4.— The  cervical  vertebra;  seen  from  behin(i  and  partly  from  the  side  (f ). 

Fir,.  5.— The  fifth  cervical  vertebra  seen  from  above  ( } ). 

Fig.  6. — The  seventh  cervical  vertebra  seen  from  above  (|). 

Fig.  7. — The  atlas  seen  from  above  (|). 

Fig.  8. — The  axis  seen  from  above  (J). 


bodies  arc  relatively  small,  low,  oblong  for  quadrilateral  with  rounded  corners),  and  thev  in- 
crea.se  in  size  from  above  downward.  The  Ixxlies  arc  smaller  than  in  any  other  region  of  the 
spine,  and  their  u]5pcr  surfaces  are  concave  from  side  to  side  and  slightly  con\e.\  from  before 
backward,  while  the  lower  surfaces  an.-  concave  from  before  backward  and  slightly  convex  from 
side  to  side.     As  a  consequence  of  this,  the  upper  surface  of  every  vcrte})ra  projects  laterally 

beyond   the   body   of   the   \ertebra  ne.xt    abo\e 
(Figs.  3  and  4). 

The  arches  of  the  cervical  vertcbne  (Fig.  5) 
are  of  medium  height  and  ari.se  by  a  pedicle  which 
is  directed  outward  and  backward.  Together  with 
the  body,  the  arch  surrounds  a  s])inal  foramen 
which  is  ver\-  wide,  especially  in  its  transverse 
diameter.  The  articular  proces.ses  (with  the  e.\- 
cc[)tion  of  tho.sc  of  the  upper  two  vertebra')  are 
])laced  obliquely,  so  that  the  plane  of  the  articu- 
lation pa.sscs  from  above  downward  and  from 
before  backward,  and  the  articular  surfaces  are 
consequently  in  a  midrlle  position  between  a  hori- 
zontal and  a  frontal  jilane,  tho.sc  nearer  the  skull 
approaching  the  horizontal  position,  and  those 
ncarci  the  thoracic  vertebra;  the  frontal  plane. 
The  transverse  processes  (P'igs.  5  and  6)  of 
all  the  cervical  vertebrae  arc  perforated  by  a  large  round  foramen  {joramcn  Iransvcrsariiim), 
a  peculiarity  which  distinguishes  the  cervical  from  all  other  \ertebra'.  Furthermore,  the  ends 
of  the  transverse  proces.ses  are  ])rolongcd  into  two  Uibercles  separated  by  a  groove  (sulcus  itrni 
spinalis)  (Fig.  5),  situated  u])on  the  surface  of  the  transverse  ])rocess. 

The  anterior  nwt  (if  the  tr.insverse  iiriiiev-;,  whii  h  passes  cliret  lly  oulwaril  from  the  ImkIv  of  the  vertelira  and  is 
.separated  from  the  |K)slerior  root  by  the  foramen  transversarium,  the  sulcus  ncn'i  spiiuilis,  and  the  eonslrietion  between 
the  two  tutjercl  s,  is  known  as  the  eostal  proeess  {processus  coslarius),  and  represents  a  rudimentary  rib  adherent  to  the 
true  transverse  process  whieh  is  represented  by  the  posterior  root.  This  eostal  process  is  ok  asionallv  independent, 
especially  in  the  seventh  rervieal  vertebra,  and  forms  then  a  cer\i(al  riti. 

The  s])inous  processes  (Figs.  4  and  5)  arc  for  the  most  part  small,  somewhat  downwardly 
inclined,  and  distinctly  bilid  at  their  apices. 

From  the  third  to  the  sixth  the  cervical  \ertebra;  arc  typical.  The  seventh  (Fig.  6)  is  dis- 
tinguished by  jjossessing  a  long  spinous  process  which  is  rot  bifid  and  is  directed  downward. 


Fig.  jj. — Cervical  %ortebra'  seen  from  in  front. 


(idoiUo,  i  process 


I  ransvcrst 
pivoss 


vr  lor 
'III  iirtiiv 


S/)iiii>iis  prori'ss 


Arch 


Siipniiir  iirliruliir 
fiicil  IpiiHrssi 


I  I'riinicii 
iiisvirsiirhiin     Body 


\'!h  I  :.'!■  iiihririi-  •'/ 
/'.'-;.  )/>;■  iiihriilr  .'I 


Hi!. 


iviiith  iirvirul 
VI  itilirii 


Spiihni^  pr.nrss 


Odoiiioiil  proii.^<. 
(iiiilirinr  iirliniliir 

fllCCti 

Superior  drlinilur  Pant 


Siiprn'or  iirliniliir 
fiiirt  tpr(>ii\\) 


f lo.   0. 


I'o^ttrior  tiiluirlr 


Infrrior  Body 

iirliaihir 
facet 

H<r,    S. 


Siipnior 
articular 

I'llCCi 


(jri'i'vc  for 
vertebral  artery 


/ raiisvcr-<e  /troccss 

f  oranien  traii^vi  r<ariii 


I  alcral  ma 


.\nl,  -ior  tiiher.le 


r.vv-?:^!!^  ^ 


THE   VFRTKBRAI.   rOI.I'MN. 


25 


and  in  these  respects  the  form  of  the  vertebra  approaches  that  of  the  thoracic  vertcbr.T.     Its 
spinous  jirocess  is  the  uppermost  one  discoverable  by  paljjation,  and  the  bone  is  therefore  al 
known  as  the  vertebra  prominens.     The  anterior  tubercle  of  its  transverse  j)rocess   is   eitlu 
entirely  or  abiost  entirely  absent,  and  the  foramen  transversarium  is  usually  smaller  than  in 
the  other  cervical  vertebra*. 

The  first  cervical  vertebra,  or  atlas  (Fif;s.  \  and  7),  is  characterized  by  a  seriis  of  negative 
peculiarities.  The  body  ."s  absent,  but  in  its  place  we  find  an  anterior  arch,  opjiosite  the  custo- 
mary posterior  arch  which  the  lx>ne  a..^o  ])os';"sses.  The  spinous  process  is  also  wanting,  its 
place  btinK  taken  by  a  jirominence  known  as  the  ])osterior  tulxTcle,  correspondini,'  to  which 
there  is  an  anterior  tubercle  upon  the  anterior  arch.  Finally,  instead  of  articular  processes, 
it  possesses  two  upper  and  two  lower  articulaiuif;  su'  faces,  and  lx)th  the  superior  and  the  infc  rior 
vertebral  notches  are  absent. 

In  the  atlas  there  are  distinj^uishable  therefore  :  anterior  arch,  a  jjosterior  arch,  and  the 
connecting  lateral  masses,  which  are  thi-  stron  ;est  portions  of  the  Ijone.  The  anterior  arch  is 
shorter  and  weaker  but  hi<,dier  than  the  posterior  one;  anteriorly  (ventrally)  it  presents  a  slight 
projection,  the  anterior  tubercle;  i>osteriorly  (dorsallv,  /.  c,  toward  the  spinal  v,;mal)  a  round 
hallow  articular  surface  (joi'ea  articidaris  dentis),  for  articulation  with  the  txlontoid  jirocess 
or  dens  of  the  axis  (the  second  (^irvical  vertebra). 

The  posterior  arch  of  the  atlas  bears  ujion  its  posterior  surface  a  short  i)roji(iion,  the  pos- 
terior .uberclc,  a  rudiment  of  the  spinous  process,  and  is  the  lowest  of  all  the  arches  of  the 
cer.'ical  vertebra-  (and  in  fp.ct  of  all  the  vertebra?).  It  is  Hat  and  broad,  howewr,  and  presents 
U])on  its  upper  surface  near  the  pedicle  a  furrow  wliieii  is  sometimes  shallow  and  sonnlinies 
broad  and  deej),  and  which  is  (K:cu])ied  by  the  vertebral  artery.  This  i,'r(H)\c  is  ndt  infrec]uenlly 
bridged  over  and  converted  into  a  foramen  or  short  canal  with  a  rough  inner  margin. 

The  inner  portion  of  each  latend  mass  of  the  atlas  (tuberositas  atlautisi  projects  markcdlv 
into  the  anterior  juirt  of  the  sjjinal  canal,  so  that  the  latter  is  converted  into  a  smaller  anterior 
comi)artmcnt,  for  the  reception  of  the  odontoid  jirocess  of  the  axis,  and  a  larger  posterior  com- 
partment. This  j)Osterior  compartment  is  really  the  spinal  foramen  and  lonlains  the  spinal 
cord.  U])on  the  upper  surfaces  of  the  lateral  masses  are  the  u])i)er  articular  surfaces  for  the 
reception  of  the  occijjital  condyles.  These  surfaci's  are  Ix'an-shaped  and,  correspon<iing 
to  the  convi'xity  of  the  condyles,  they  are  concave  from  anteriorly  and  withir  to  posteriorlv 
and  without.  In  the  middle  they  are  constricted  and  occasionally  divided.  On  the  under 
surface  of  the  lateral  masses  arc  found  the  inferior  articular  surfaces  which  serve  for  ariic  ulalion 
with  the  second  cervical  vertebra  and  resemble  the  similar  surfaces  of  the  other  vertebra-  more 
than  do  the  superior  articular  surfaces,  possessing  plane,  but  slightly  incluied  (almost  lidri/ontal) 
surfaces. 

The  transverse  ])rocesses  exhibit  the  s;ime  characteristics  as  the  transverse  processes  of 
all  the  cervical  vertebra?,  but  are  larger.     Like  the  others,  each  jiossesses  a  foramen   trans\er 
sarium,  i)ui  the  sulcus  nervi  sfjinaiis  and  the  tulKTcles  are  al)sent. 

The  second  cervical  vertebra  (Figs.  4  and  8),  or  axis  iepislropheus),  so  calkd  be(ause  tin 
occiput  and  the  atlas  rotate  ujwn  it,  is  on  the  whole  a  typical  cervical  vertebra,  except  thai  its 
body  has  adherent  to  it  the  original  body  of  the  atlas,  whiih  t'orms  the  odontoid  process  idens 


.1  ,>ri(i"V'  " 


.•^ '"5^^ 


r-rt'- 1 


ATLAS    AXD    TEXT-HOOK    OF    HirMAX   AXATOMY. 

9.— The  tenth  to  the  twelfth  thoracic  and  the  first  and  second  lumbar  vertebra^  seen  from  the  side 
and  sliijhtly  from  Ijehind  (J). 
Fig.   10. — The  tenth  thoracic  vertebra  from  above  (',). 
Flc.   II. — The  sixth  thoracic  vcrtelira  from  the  side  (|). 
Fic.  12. — The  third  lumbar  vertebra  seen  from  above  ({). 


epistrophei)  and  projects  into  the  anterior  compartment  of  the  spinal  foramen  of  the  atlas.  This 
odontoid  j)roce.ss  is  conc-shapec!  with  a  rounded  apex,  and  presents  an  anterior  facet  for  articu- 
lation with  the  anterior  arch  of  the  atlas  and  a  posterior  articular  facet  which  is  not  alwavs  dis- 
tinct. Instead  of  articular  ])rocesses  the  ujiper  part  of  the  body  presents  corres])onding  articular 
surfaces  for  connection  with  the  atlas;  tliese  surfaces  are  slii^htly  con\ex  and  bu;  1  trille  inclined 
from  the  horizontal. 

The  spinous  process  {Y\'^.  4)  is  fairly  well  developed  and  always  distinctly  bifid;  the  trans 
vet'se  i)roces.se-.  on  the  contrary,  are  smaller  than  those  of  the  atlas  and  their  lulxTcles  and  sulci 
nervi  spinalis  are  likewise  absent,  although  there  is  usually  a  shallow  groove  for  the  second 
spinal  nerve  on  each  side  Ix'hind  the  superior  articidar  facet.  The  inferior  articular  |)roces.ses 
are  more  inclined  than  the  superior  ones,  and  already  show  the  characteristics  of  those  of  the 
flexion  vertebra'. 

The  fciramina  transversaria  of  ihc-  artinilatnl  <or\ii  il  vcrtrtira-  form  '  canal  for  ihc  passage  of  thr  vcrti'liral  arlory 
ami  vein  (the  fornirr  runs  ■  .mxf.'n  the  u|i|kt  six  only).  The  markeilly  ilevelopeil  anterior  tiihiTi  le  of  ihe  Irnnsversi-  pro- 
ress  of  ihe  sixth  cervical  vertel)ra  is  known  a^  the  <  arotiil  luherrle  or  IuIhti  le  of  ChassaiRnae  {luherciilum  cnrotkuni). 

THE  THORAQC  VERTEERJE. 

On  account  of  tin  independent  de\cloiiment  of  the  ribs  in  the  thoracic  region,  we  Imd  no 
fused  costal  rudiments  in  the  thorat  i(  vert(  l)r;e  such  as  (Kcur  throughout  the  remainder  of  the 
true  vertebr.e,  ami  the  thorat  ic  \erlebra'  are  consequently  of  the  jiurest  ty])e. 

Their  Ixxlies  (Figs.  (),  10,  11,  and  21)  increase  in  si/.e  and  height  from  alx)ve  downward. 
In  the  ui)|>er  thoraiic  certebr.T  their  surfaces  are  elliplital,  like  those  of  the  cerxical  region, 
but  as  we  jiass  downward  they  betome  rounder,  then  cordifomi,  and  fmally  reniform  in  the 
lower  nn  nilxrs  of  the  series,  which  approximate  the  form  of  the  lumbar  \erlebra'.  And  not 
only  do  tile  iKxlies  iK'conie  largir.  but  their  lateral  diameter  especially  is  increa.sed  as  they  gradu- 
ally approach  the  form  of  the  lundjar  \ertelira'.  Their  (dniigiious  surfaces  are  almost  per 
fectly  tlat.  The  spinal  foramen  (Fig.  10)  is  not  only  absolutely,  but  even  relatively  smaller 
tlum  that  of  th  tervital  vertebra',  and  in  the  upper  memlnrs  of  thi'  scries  it  is  roimded,  wiiiK 
in  th(  lower  <'.  it  is  rather  triangular.  The  upix-rand  lower  margins  of  the  Ixxiieseach  present, 
imtnedialel}  in  front  of  the  petlicles,  a  demifatct  for  the  head  of  a  rib  (Fig.  11  ).  The  first  ami 
the  two  (or  three)  lowest  vertei)ra',  however,  thuw  de\iations  from  this  arrangement,  the  former 
having  an  entire  facet  u|M)n  the  upper  margin,  anil  each  of  the  latter  (Fig.  ())  ]iresenliiig  an  entire 
faiel  toward  the  niiddle  of  ihi  1mm1\  of  (he  Mrlebra. 

The  arti'  ul.ir  surfat  e^  for  the  he.ni^  ol  the  rit^^  are  plaied  on  two  ailjad-nt  thorat  it  vertelira'  in  ^iii  h  a  manni-r 
Ihiit  eaih  \erteliral  niarnin  i|ihs  not  rei  eive  exaitly  ..I'l   half  of  the  arlii  illation,  hui  lowani  Ihe   lower  eml  of  th(    seriis 


if  ii^-ith-r  iw--'!:i,-!---f  i!-.-rmir- 


^m'WM 


i'nci-t  f(V  haul  <>/'  rih 


Superior  (irtinilur  proass 


Spino:!^  /Vi'iv 


/(•/////  r/ionnu 
vrrtchni 


iwclfih  t/iiviii/r 
vrrtrhrti 


I  irsf  linnlnu 
vi  rliinu 


I  rmiwi'  -.r  priii<-^  ^ 


I  iiiil  h'r  tii/irnii- 
ill  rih 


Siip,rior  uriirtihir 
prOd  ■.^ 

i't  rJi 


I  /".  10. 


Siiiih>:i^  pr.'ii 


liiliiiiir  (inidiliir  iiiiHf.\ 


Spiiu'ii-^  pu'ii 


Sn/hru'iui'iiii/'ir  pr,h 


/ /iff/'V, r\t'  pitUi  '•'* 


/■'A-    '-' 


M^Sl^llM..^^ 


■'i%/:i^.:::i.i^.j»^^^-k 


THE   VERTEBR^VL  CvJi-UMN. 


27 


ally  the  tenth  also,  possesses  an  entire  rostal  facet  'Fig.  25).     These  vertebra;  which  [x)ssess  an  entire  facet  have  typically 
n<i  inferior  facet. 

The  arrhfs  of  the  thoracic  vertebra'  (Fig.  lo)  are  hi>;h  and  thick.  The  articular  })rocesses, 
with  the  excejjtion  of  tliose  of  the  twelfth  \ertil)ra,  he  almost  in  the  frontal  jilanc  and  are  placed 
so  that  tile  almost  round  and  slij^htly  concave  inferior  surfaces  l(x>k  forward,  while  the  >lightl\ 
convex  -aperior  ones  look  backward,  the  surfaces  forminj;  part  of  a  thick  cvlimler  the  axis  of 
which  lies  in  front  of  the  vertebral  body.  The  superior  processes  are  ver\  ]in>miniiit,  while 
the  inferior  ones  project  but  slij^htlv. 

Th(  long  transverse  processes  (Fiji;.  10)  are  strongly  develojicd.  They  are  directed  back- 
ward as  well  as  outward,  and  have  thickened  club-shaped  extremities.  The  anterior  surfatr 
of  this  thickenin.!^  usually  ])resenls  an  a])i)roximately  circular,  slij,'htlv  conia\e  arliiiilar  face!, 
for  the  accommodation  of  the  tubercle  of  a  ril);  this  facet  is  wantinj;,  however,  in  the  eleviiilh 
and  twelfth  vertebra'  (Fij^.  q),  and  the  transxcrse  i)roce.ss  of  the  latter  often  shows  a  \ariable 
develo])ment,  freipiently  consistinf^  of  *■  'veral  irrej^ular  tubercles. 

The  spinous  processes  (Fif^s.  (),  10,  and  2?)  a^     '  nj;  and  three-sided,  and  are  directed  ob 
li()uely  downward,  one  border  looking  U])ward  and  one  surface  downward.     Those  of  liie  midiile 
vertebra"  of  the  series  overlap  each  other  like  the  shingles  of  a  roof  ( Fig.  j  ? ).     That  of  the  twell  ih 
vertebra  (Fig.  (j)  resembles  those  of  the  lumbar  vertebra'. 

'I  he  twelfth  thnraiic  vertebra  (ami  scimetinies  ihi-  eh  venlh  aUo)  i-.  the  only  one  that  1  an  Im'  <le,-,iKnalr(l  as  atypical, 
since  it  exhibits  several  characteristics  ..f  the  lumbar  vert4bra-  (the  shajH'  of  the  spin.jtis  pn«  ess,  body,  ami  spinal  forani.-n, 
the  |K)sili.in  of  the  articular  priHcsses  an<l  the  appearand  of  the  accessory  ant]  ni.ininiillary  pro.  esses  ii|i.)ii  llic  nidi- 
mentary  transverse  proies.ses).  The  facet  f.)r  the  head  of  the  rib  alone  sIiohs  the  Iriic  nature  of  the  twelfih  lhor.ni. 
vertebra,  just  as  the  fatets  upon  the  boilies  (and  transverse  proii>ses)  ,ir(  the  surc-t  points  of  ideniilication  for  the  thorai  i. 
vertebra'  in  general 

THE  LUMBAR  VERTEBRA. 

The  lumbar  vertebra-  (Figs,  o,  12,  :i,  and  2;,)  are  the  largest  of  the  true  wriebra'.  The 
bodies  in  partiiular  are  large,  very  high  and  broad,  and  have  plane  reiiiform  siirtaces,  /.  c, 
they  are  convex  anteriorly  and  concave  j)0.steriorlv.  The  anterior  surface  is  distinctly  cuniavc 
from  above  downward  and  convex  from  side  to  side,  so  ih.il  the  up|)(  r  and  lower  siirfatts  of 
the  bodies  are  con.'<iderably  liroader  than  their  middle  portions.  .Also  the  Itodies  of  the  lower 
lumbar  vertebra-  at  least  (and  especially  of  (lie  fifth)  are  disiincily  higher  anteriorly  than  pos- 
teriorly (Fig.  j^). 

The  arihes  of  the  lumbar  vertebra  (Fig,  12)  are  strongly  dtvelojied  an<l  \erv  high,  but 
show  no  further  |.eculi,iniies;  the  spinal  foramina  are  ,sm;dl  and  appn  .imalelv  triangul.ir. 
The  articular  processes  are  well  formed  and  projeit  markedly  bolli  alxive  ,in,l  below,  and  the 
articular  surfaces  are  slighll\  curved  and  are  almost  in  the  s.igiiia!  ,.i,ine,  the  tomavity  of  the 
upper  surfates  looking  backward  and  inward  while  the  convexity  o,  ih(  lower  ones  i>  directed 
forward  and  outward.  The  surlaiis  represent  seitioiis  of  a  lar^'e  hollow  <  vlinder.  whose  axis 
is  situated,  not  in  fnmt  of  the  vertel.-ral  bodies,  as  in  the  thoracit  region,  but  iH-hin.l  ihi  in  lU  hind 
the  spinous  process),  and  the  inferior  pro(  e>ses  of  each  vertebra  are  n)nsei|uentlv  oMrlappeij 
laterallv  In  the  superior  processes  of  the  next  su(ceeding  one.  The  infi  rior  pnM'esses  of  the 
iiilii  Miiibr.i  are  united  wiiii  the  U|iper  arlii  ul.ir  proic.s.ses  o|  Ihr  sai  ru">  1  see  jiage  jcj). 


»  ,-.fey  5 


28 


ATLAS    AM)    TEXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  13.— The  sacrum  seen  from  behind  (dorsal  surface)  (j). 

Fig.   14. — The  sacrum  seen  from  in  front  (i)elvic  surface)  (|). 

Fig.   15. — The  sacrum  seen  from  al)ovc  (ba.'^e)  (J). 

Fig.   16.— Horizontal  section  of  the  sacrum  at  the  level  of  the  second  sacral  foramina  (J). 

Fig.   17.— Median  lonjrituchnal  section  through  a  sacrum,  showing  the  synchondroses  between  the  n- 

vidual  vertcbnu  (j). 
Fig.   18. — The  .sacrum  and  coccy.x  seen  from  the  side  (*). 
Fig.   ig. — The  coccy.x  seen  from  in  front  (j). 
Fig.  20. — The  coccvx  seen  from  behind  ( {}. 


The  transverse  ])r()ccsses  of  the  lumbar  vertebra?  (Fig.  arc  lonR,  (lirccted  almost  at  a 
right  angle  from  the  sjjinal  column,  and  <listinctly  comijressed  from  before  backward.  They 
represent  ru(limentar\-  lumbar  ribs  and  are  therefore  really  the  costal  ])rocesses,*  while  a  small 
])rojeclion  situated  at  the  base  of  the  "transverse  jtrocess,"  tlie  iiccrssiiry  pmrss  (Figs.  9  and 
12),  corres])onds  to  the  lrans\erse  ])r()Cess  of  the  thoracic  vertebra'.  Tiiis  accessory  process  is 
characteristic  for  the  lumbar  vertebra-,  and  although  .sometimes  ])Oorly  niaiked,  it  usually  a])- 
])ears  even  in  the  twelfth  thoracic  xerlelira.  The  superior  articular  jirocesses  of  the  lumbar 
vertebrx-  also  exhibit  another  round  roughened  protuberance,  the  maimmtUiry  process  (Figs. 
gand  12). 

The  sjii   JUS  jirocesses  (Figs,  q  and  12)  are  very  strong  and  high  and  are  distinctly  com 
pressed  from  side  to  side.     The_\-  extend  directly  backward  and  show  a  slight  thickening  at 
their  apices. 

The  False  Vertebr.e. 

The  false  \ertebra',  whidt  are  \ariable  in  number,  form  two  lx>nes,  the  .sacrum  and  the 

l(HC\  x. 

THE  SACRUM. 

Tite  sacrum  is  that  ])ortion  of  the  \crubral  u)lunin  which  is  connected  with  the  jieKic 
girdle  and  completes  the  latter  posteriorly;    it  cons-i|"  ntly  forms  a  i)ortion  of  the  |)elvi>  itself. 

It  i>  a  broad,  uir\cil,  nuMlcrat-'ly  flat,  shovel  shaped  bnin-  1  Figs.  1;,  and  14),  which  is  broad 
and  tiiick  above,  and  narrow  and  thin  below  (Fig.  iSi.  I  it  there  may  1k'  distinguished  an 
anterior  relatively  smooth  surface,  concave  in  both  the  sagittal  and  tr:ins\er>e  dircdion--,  ami 
known  as  pehic  surfaii,  bciausc  it  looks  toward  the  pehic  cavity,  and  .1  posterior  exlreinely 
rough  dor>al  surface.  The  broad  iijiper  surface  of  tlu'  s.icrum  is  c:dle(l  the  base  and  the  lower 
angle  the  ajiex. 

The  pchii  surface  presents  a  number  of  traiisverM'  ridges,  usuallv  lour,  which  connect 
fur  pairs  of  irregtilar  rminiltd  foramin.-.  known  as  the  anterior  sairal  foramina.  The  ridges 
corresixmd  to  the  jumlion-,  ol  the  ii\e  originalb  ^ejiarate  sacral  \trtebra'  of  which  the  bone 
i>  composed,  while  the  >.u  r;d  I'oraniina  indicate  tlu  juiutioiis  of  \hv  Ixxlies  with  tlu-  lateral  jiro- 
ces.ses   (costal    and   transverse    proce.^se.-i.     The    anterior    sacral  foramina    communicate    pos- 


•  Tticsi-  priKC" 


tic  ( ,i-.ii>n:illv  f.rrm  Miiallcl  iil.iliiniiii.il  ur  lunilur  rili> 


EmfM^amm 


^!n "  .* 


v^^:-. '^-vi?'?^    y^- 


BV- 


'^'■A^^-S^i 


^mmsm^^mm 


0^- 


•5  3 


l^^f 


'N.. 


'X.i 


S;T%5^ 


Miilidil  sdcnil 
Posterior  sdcrol  rnst 

forninai  .^  lnlmrrl<bnil 


Ihl^l-   of  M/I77/W 


.%  iiin  t  \  i  I  It  ih 

Sacral       f  S)  Jorunni, 

''"""'JiK 


V  Wi^: 


Sii/ii  nor 
inliriiliir 
I'ronss 


fiir  10 


I hinl.   loiiilh  ,iiul  tillh  i,>,i\i;riil 
vi  rlihrui 


'^.  liA'^^i'^mit!:- 


liL-rt^Nfii 


THE    VERTEHRAL   COLUMN. 


2() 


tcriorly  with  the  spinal  canal  and  extend  laterally  as  gnxives  which  gradually  become  shallower 
and  are  finally  lost  upon  the  lateral  masses  of  the  Ijone. 

The  portions  of  bone  situated  external  to  the  sacral  foramina  and  which  are  jjarticularly 
well  developed  in  the  up[)er  ])art  of  the  sacrum,  where  they  articulate  with  the  pelvic  girdle, 
are  designated  as  the  lateral  masses  (partes  hiUralcs)  (Fig.  15).  Their  lateral  surfaces  exhibit 
large  ear-shaped  articular  surfaces,  known  as  the  auritular  surjaccs,  which  articulate  with  the 
pelvic  tones,  an<l  occur  chiefly  ujion  the  first,  to  a  limited  extent  u])on  tlu'  second,  and  even 
upon  the  third  sacral  vertebra  (Fig.  18).  Behind  the  auricular  surfaces  there  is  an  irregular 
rough  impression,  the  sacral  lubcrosily  (Fig.  i.:;),  which  is  united  by  a  ligament  with  a  similarly 
named  i)art  of  the  jielvic  lx)ne  (see  ])age  95).  .\t  the  junction  of  the  base  of  the  sacrum  and 
the  pelvic  surface  there  is  a  feebl\  marked  line,  the  sacral  portion  of  the  ileoi)ectineal  line  (linca 
lerminalis),  which  separates  the  true  from  the  false  ])elvis. 

The  up[)er  surface  of  the  sacrum  (F'ig.  15)  also  possesses  a  slightly  uneven  surface  intended 
for  articulation  with  the  lower  surface  of  the  fifth  lumbar  vertebra.  The  form  of  this  surface 
exactly  fits  the  corresponding  surface  of  the  Inxly  of  the  fifth  lumbar  \ertebra  and  ixhibits  all 
the  character;  ics  of  a  lumbar  vertebra,  including  a  superior  vertebral  notch  and  a  superior 
articular  prtKess. 

The  dorsal  surface  of  the  sacrum  (Fig.  i  ^"1  has  four  jiairs  of  rounded  foramina  which  ex- 
acilv  corresi)ond  in  their  position  to  the  anterior  ones.  In  addition,  it  exhibits  a  series  of  ])arallel, 
rough,  frequently  interrupted  ridges,  a  median  single  ridge,  and  two  rows  of  paired  ri<lges.  The 
median  ridge,  known  as  the  rrcsl,  consists  of  the  more  or  less  fused  spinous  j)r(Kes.ses  of  the 
five  .sacral  vertebra',  and  is  more  pronounced  than  the  lateral  ridges.  These  (Fig.  i,0  are  sepa- 
rated  by  the  posterior  sacral  foramina,  the  inner  ridge  known  as  the  articular  en  si  and  thi'  outer 
one  as  the  lateral  crest.  The  former  is,  as  a  rule,  the  least  jironounced  of  all  tlu-  ridges,  and 
is  formed  by  the  fusion  of  the  articular  jirocesses  of  the  sacral  vertebra-,  only  two  of  these  |>ro- 
cesses  on  each  side  retaining  a  certain  degree  of  independence,  the  su])erior  ])nKe.s.ses  of  the 
first  vertebra  and  the  inferior  ones  of  the  fifth.  Tb.e  former  lie  at  tlie  ba>e  of  the  s;icrum  and 
are  called  the  superior  articular  processes  of  the  sacrum ;  they  articulate  with  the  inferior  articular 
])r(Kes-i  s  of  the  last  lumbar  verlel)ra  and  are  ei|ually  well  fomied.  Their  articular  surfaces 
arc  ])laceft  midway  between  the  sagittal  and  the  frontal  plane.  The  articular  crest  is  ((inlinucd 
downward  on  i-ach  side  o\er  the  apex  of  the  sacrum  and  usually  jirojects  beyond  it  as  a  horn 
like  process  called  tlie  sacral  cornit.  This  process  is  the  modified  lowennosl  articular  )inicess, 
and  is  unitt'd  b\  ligaments  to  a  similar  process  on  the  coccyx. 

Tlu-  lateral  sacral  crest  is  lo  be  regardi-d  as  fornu-d  by  the  fusion  of  tlu-  tran>\irse  proces'-es 
and  forms  a  nnigli  riilge  which  i^  occasionally  interrupted. 

Tlu-  sacrum  is  traxersed  throiiglunit  its  lengtli  b\'  a  canal  1 1'"ig.  17)  whiih  !■  tlu-  dii-ed  con 
linuaiion  of  the  s|iinal  canal  and  is  known  as  tlu-  sacral  canal.  It  is  toK-raiily  widt-  in  the  ujiiicr 
part  of  the  sacrum,  but  ra])idly  diminishes  in  Ixuh  its  .s.ij,.aal  and  transx-er.se  diaiiuters  as  it 
descends.  It  terminates  externally  Ixtween  the  sacral  cornua  as  the  saa-al  hiatus  ( l-'ig.  1^1, 
and  is  connected  wiiii  the  anterior  and  ])oslerior  sacral  foramina  by  four  short  ii-a  ,,\'erse  canals, 
ilu-  iittm-rrtihrii'  jorantlnu  (Fig.  1(1). 

The  jjosterior  wall  of  the  sacral  canal  is  formed  cs.sentially  by  the  completely  fused  arches 


i^^^XjIUA^ 


3° 


ATLAS    AND   TEXT-BOOK   OF   HUMAr;    ANATOMY. 

Flc.  2 1 . — The  vcrtel)ral  column  seen  from  in  front  (§). 
Fig.  22. — The  vertebral  column  seen  from  behind  (§). 
Fig.  23. — The  vertebral  column  seen  from  the  left  side  (J). 


of  the  sacral  vertebrx.  The  inter\-crtcbral  foramina  corrcsiwnd  to  the  similar  structures  in 
the  true  vertebra' ;  but  in  the  latter  there  arc  no  openings  comparable  to  the  sacral  foramina, 
at  least  not  in  the  bony  spinal  column.  This  is  due  to  the  fact  that  the  spinal  nerves  divide  into 
an  anterior  and  a  posterior  branch  within  the  sacral  canal  instead  of  outside  of  the  spinal  canal 
as  in  the  true  vertebra-,  or,  to  go  back  a  stej)  Turther,  it  is  due  to  the  fact  that  whereas  throughout 
the  scries  of  true  vertebra'  the  ribs  or  costal  processes  remain  distinct  from  one  another,  in  the 
sacrum  the  costal  ])rocesses,  which  are  rci)rcsented  in  the  lateral  masses,  fuse  together  and  a'.^o 
unite  with  the  transverse  processes,  so  that  the  intervertebral  canals  are  closed  at  their  outer 
ends. 

The  a])cx  of  the  sacrum  presents  an  elliptical  surface  for  articulation  with  the  coccyx,  and 
at  its  sides  there  is  a  shallow  notch  which  is  converted  into  a  foramen  by  the  transverse  process 
of  the  first  coccygeal  vertebra  and  the  connecting  hgaments  (sec  page  n.^). 

THE  COCCYX. 

The  coccyx  (Figs.  18,  iq,  and  20)  is  a  small  bone  of  variable  length  formed  by  the  fusion 
of  four  or  tive  (rarely  three  or  six)  (juite  rudimentary  vertebne  (vcrlchnr  caudalcs).  The  first 
vertebra  alone  shows  some  vertebral  characteristics,  since  there  can  be  recogni/.ed  in  it  indica- 
tions of  transverse  processes  as  will  as  of  the  up]ier  articular  ])rocesses  which  are  transformed 
into  the  ciuryi^ial  coruiia.  The  transverse  processes  also  freiiuently  a])])ear  in  the  second  ver- 
tebra in  the  shajic  of  feeble  indistinct  i)rojections,  but  the  remaining  coccygeal  vertebne  are 
irregular,  rounded  jiiece ,  (,f  l)<)ne.  None  of  the  coccygeal  vertebr;e  ])ossesses  a  trace  of  \ertebral 
arches  or  of  a  spinous  process,  and  the  individual  vertebne  are  united  either  by  syi  nondroses 
or  (more  rarely)  by  Ijony  tissue. 

Thi'  sacrum  sHdws  ivpicjl  st\u:il  dilTirciu  is,  since  it  is  Ijrcwdir.  shortiT,  ami  less  curviil  in  tlic  ft  ni.ilc  than  in  the 
male.  Nut  infrc(iui-nllv  the  lir-l  sai  ral  vertebra  remains  jiartlv  c.r  cm  n  eiuirely  inilejiendent  (Ihc  lnntl'iis<iir,il  irrlcbra), 
and  the  first  coccvgeal  vertebra  frequently  fuMS  with  the  sacrum,  in  which  laM'  the  sairal  and  cixcygtal  ii.rniia  are  also 
united  by  tjiiny  tissue, 

THE  VERTEBRAL  COLimiN  AS  A  WHOLE. 

The  vertebral  column  is  completed  by  its  ligamentous  connections  and  particularly  by  the 
intervertebral  di.scs  situated  between  the  IxKlies  of  the  vertebra-  (see  page  no).  If  the  bony 
\ertebral  column  be  observed  from  tile  side  (Fig.  2;,^  its  marked  curvature  al  once  becomes 
apiKirent.  This  curvature  is  manifold,  the  cervical  portion  of  the  column  being  convex  ante- 
riorlv,  the  thoracic  |)ortion  markedly  toncave  anteriorly,  the  hmibar  portion  decidedly  convex 
anteriorlv,  and  the  sacrum  concave  anteriorly.  .\l  the  juncti(m  of  the  lurnbar  ])ortion  with 
the  sacrur!%  where  the  convexitv  of  \]w  former  passes  into  the  concavity  of  the  latter  there  is 
a  inarkeil  angulation  (ailed  the  promonlory.  Tiie  curvatures  of  the  vertebral  column  are  sub- 
ject to  individual  variation. 


y- 1- .  , .  5fc^A---' 


('iTviCdl 

irrli'bnn 


1  lioracir 
verlfhnic 


I  iiiiibtir 
viilihriii 


Murium 


li:hi\-iiiihnil 
loranniiii 


M 


'•^ia"v -r'  '*'n 


rttii 


f 


KOlft 


Tin:   VKRTEBRAl,  COI.UmX. 


31 


In  viewing  the  vertebral  column  from  in  front  (Fif;.  21)  h  will  be  noticed  that  the  sacram 
is  bv  far  the  broadest  part  of  t'n'  spine.  From  here  ii]iward  the  vertebral  column  becomes 
smaller  until  the  fifth  thoracic  vertebra  is  reached,  whence  it  commences  to  enlarKe  as  it  ascends. 
in  the  upper  cervical  refjion  the  column  again  decreases  in  size,  but  the  alias  is  broader  than 
the  bones  which  lie  below  it.  .\  study  of  llie  ])roiile  of  llie  sjiinal  column  (Fig.  23)  shows,  liow- 
ever,  that  its  greatest  thickness  is  found  in  the  lumbar  region. 

Just  as  the  anterior  surface  of  the  verleljral  column  is  completed  by  the  intiTvertebral  discs 
between  the  bodies  of  the  individtial  vertebra',  so  too  the  s])aces  between  tlie  arches  are  simi 
larlv  filled  by  ligamentous  tissue.     These  spaces  are  largest  in  the  lumbar  region  and  between 
the  two  upper  cervical  vertebne  (Fig.  22),  in  the  latter  instance  becau.'-e  the  arcli  of  the  atlas 
is  extremely  low. 

The  spinal  canal  (caiuiH;  i-irlchralis),  lormed  by  the  spinal  foramina  of  the  individual 
vertebra?,  has  not,  therefore,  a  uniform  bony  boundary  even  in  the  region  of  the  true  vertebra', 
but  at  intervals  is  covered  in  only  by  membranous  structures.  It  communicates  laterally  with 
the  intervertebral  foramina  (Figs.  2.^  and  t,6),  each  of  which  is  fornn'd  by  two  Ncrtebra-  alx)\e 
it  is  continuous  with  the  cranial  cavity;  and  its  lower  end  is  formed  by  [hv  satnil  liidlu.s,  wliicli, 
however,  is  almost  completely  closed  by  ligaments. 

There  are  twentv-three  pairs  of  interverteliral  foramina,  six  in  the  cervical  region  (see  page 
26),  twelve  in  tlie  thoracic  region,  and  live  in  the  lumbar  region.  Those  in  thr  lumbar  region 
are  the  largest,  while  tliose  situated  between  tlie  cervical  vertebra'  are  llie  smalksl;  between 
the  atlas  and  the  occiput  there  are  no  intervertebral  foramina  \\liate\er,  and  those  between  tlie 
atlas  and  axis  are  only  ])artially  limited  by  Ixnu.  The  lowermost  intervertebral  foramen  lies 
between  the  fifth  lumljar  verteljra  and  the  upjier  surface  of  the  sacrum.  Tl'.e  intervertebral 
foramina  in  the  cer^•ical  region  are  exactly  l)etween  tlie  transvirse  proces>es,  whili'  in  the  thoracic 
and  lumbar  regions  thev  are  in  front  of  them  (Fig.  23). 


THE  DEVELOPMENT  OF  THE  VERTEBRAL  COLUMN. 

As  far  as  tin-  (l>-v.Io|iliU'm  of  tlic  Lony  virlil^ral  ...Uinm  i-,  .Miu.rr.M!.  la.h  Mrulira  ari~is  from  ihric  .mlir-.  ..f 
os>il»ati..n,  i.iu'  fur  tin'  .icily  ami  oiu-  fnr  .  ai  h  lialf  ..f  ilu-  \,ruliral  ar,h.  Ossili.  ali.Mi  .  ..iiiiiirni  .s  at  llir  i  ii.l  ,4"  ihc 
sriiinil  mc.nih  c.f  iinhrvi.iiic  lif-,  llu-  .  ,-nti  rs  fur  thr  ari  Ins  a|.|.cariiiK  scim-^hal  rarli.  r  tliaii  tlv-c  f.ir  iln  l.ml}  i?ul  al-o 
giving  risr  t,i  llu-  ilitTiTint  v,  rtcliral  ].nKiss,>.  In  adiHliun  tu  tins,-  ihiif  ( ,nli  rs,  a. .  i  —  iry  (.  nl.  r^  .l.i.  Iu|.  ,  i,n-.i.!.  r.l.ly 
laliT,  at  the  age  of  puli' rly  or  even  sulisfi|ui-nlly,  an<l  .ii.i«ar  as  ttal  (lis,  s  on  ihr  api.t-,  ,,f  ih,  >|'in..ii,  ami  ira"-v  r-r 
|iri>'i-sscs,  on  llio  niami  illary  )ironssfS  of  the  lumliar  v.rtrl.ra-,  ami  on  ih.-  u|'i.,r  and  lo",r  ■  irfa.rs  of  tli.-  \.  :l.!.ral 
ho.liis,     Th.'s,-  iiiiphysc     do  not  uniti-  witli  the-  nniaind.r  of  tin-  v.rlt'.ra  until  thr  groMti    oi  -In-  l.ody  ha^  1.,,  nconi- 

,,lrlr,l. 

In  the  first  yr.n  ..f  lifi'  till-  two  centers  for  thr  vcrtel.ral  .in  hi-s  unilr.  i:i  tli.'  tiiivd  year  the  ar.  In^  1,.  .  onu-  jouird  to 
the  l.odies,  uiiile  the  ipii'hyses  remain  distimt  until  the  twenty-tifth  year. 

In  the  atlas  thi  iinlir  for  the  l..idy  is  wanting.  The  anterior  an  li  ren-  lin- .  ..riilaeiiiou-.  f.  ■  .,  l.nLMinie,  ii.  I  ..--ify- 
in«  unti'  the  first  v.ar,  and  not  uniting  with  the  posterior  an  h  until  the  fifth  or  sixth  >ear.  The  two  , .  nters  fur  ihi  pos- 
terior arih  remain  .separated  until  thi-  thinl  year. 

In  the  axis  there  is  a  eenter  for  tile  Lodyand  a  similar  om-  (..riginaliy  doubl.  i  foi  the  odoiUoj  ;,roeesv.  n.,th  Muile 
:„  ,u,.  !hird  vear. 

The  s.iiral  virK-bra-  ossifv  in  a  similar  mann.r  to  the  true  virlelira-,  in  (a.  h  tin  n  i-  .i  single  .  ■.  lit.  r  f^r  the  liod>, 
two  for  ea.  h  ar.  h.  epiphyseal  plate  ,  and  spei  ial  ventral  eenters  eornsp,,mling  to  the  sa,  ral  -il  -.  'i  he  l.odv  and  an  he. 
e.f  the  filth  sa.  ral  vertehr.i  unite  first  (se.ond  yearl  and  then  f.ill.iws  the  union  of  [hr  !i...lv  aii.l  ar.  he-  ..I  ih.  Iii  m  r- 
1,-hra  (fifth  and  sixth  yiMrl,  while  I.,my  uni.m  l-nv,en  the  l.o.lu's  ii.,es  n..l  ... .  ui  until  th,'  tw.  nty-hflh  y.  .r,„  lat.-r. 
In  the  r.Ki  ex  the  frst  verlehra  is  ossified  at  hirth,  the  last  one  not  until  the  Iweiuieih  \e.ir 


32 


ATLAS    AND    TFATHOOK    OF    HIMAX    ANATOMY. 


Fig.  24. — The  first  rih  of  the  ri^ht  siilc  .seen  from  above  and  from  the  siJt  (J). 

Flo.  25. — The  scconil  rih  of  the  riijht  side  seen  from  above  and  from  the  side  (I). 

Flc.  26. — The  |iosterior  extremitvof  tiie  .seventh  rib  of  the  rii^ht  side  seen  from  behind  and  partlvfrom 

below  (§). 
Fk;.  27. — The  seventh  ril)  of  the  left  side  seen  from  behind  (ij). 
Fli;.  28. — The  seventh  rib  of  the  left  side  seen  from  within  (^). 


THE  RIBS. 

The  ril)s  nosta)  helonji;  to  tlial  iimilcd  ^roii])  of  skeletal  sefjmcnts  which  remain  partly 
lartilaj^inous  throu.ijhout  life,  .\ttenlion  may  first  be  (lireded  to  tiie  tM)ny  ribs,  of  whieh  then; 
are  twelve  pairs  (Fii,'s.  2.\  and  :;o),  <  orres])on(lin,i;  to  the  nurnbir  of  llu'  ihoraiie  \ertebra-. 

The  ribs  are  not  tubular  Ixmes,  but  llat  \n)n\-  slri])S  of  considerable  lenj.;th.  Tliose  in  tlie 
middle  of  the  series  arc  (juitc  uniform  in  shaiK',  only  the  up[)er  and  lower  ones  show  in^  certain 
deviations. 

In  a  ty])ical  rib  the  foiicnvini;  parts  may  he  rccoirnized: 

I.  The  haul,  the  posterior  (vertebral)  slijjhtly  thickincd  end.  It  presents  an  arlituhtr 
surjiUi'  (Fit;.  27),  which  is  opposed  to  the  Ixxiies  of  the  vertel)ra',  and  is  marked  b\-  a  median 
ridfie,  the  rrr.sl,  wiiich  <iivi(les  it  into  an  upjier  and  a  lowir  artiinlar  surface  for  llie  two  \ertebral 
iKxiies  with  which  it  articulatis. 

.'.  The  Jictk,  a  con-iriclion  situated  external  to  tiie  lic.id  ( Fij;.  28).     Its  upper  margin  is 
formed  by  a  rid.^e,  (n.s7  oj  llir  H((k,  whiih  is  sejiarated  from  thi'  Ixxly  of  the  rib  by  a  rough  emi 
nence,  the  /itbirdi,  presenting  a  facet  for  artidilalion  with  tiie  lrans\erse  process  of  a  thoracic 
vertebra. 

3.  The  hoilv,  the  longest  part  of  the  rib.  Tliis  i^  placid  vertically  ;ind  is  distinctly  tlatlened 
from  without  inward,  .so  that  an  e\ternal  ami  an  internal  surfaci'  may  be  recognized;  near  the 
ttdxTcle  it  [iresenls  a  rough  surfaie,  the  .i(i,i,'/c  of  the  rib  (I''ig.  j8).  The  i;b  i>  at  first  tlirected 
outward,  Iwckward,  and  downward,  but  at  the  costal  angle  it  turns  tijion  il-elf  and  pa.s.ses  for- 
ward. On  the  inner  siirfaie  of  the  lower  margin  of  the  iMHly  theri  is  a  gn>o\c.  the  rosldl  f;r<nn'f 
(Fig.  2H1,  whidi  gradually  Ixiomcs  shallower  a^  it  a|ipioache^  ilir  .interior  (ostal  <'xfremify, 
and  lauses  the  lower  niaririn  of  the  ril)  to  he  sharp  while  the  ujipcr  oik-  is  more  rounded.  .\t 
its  anterior  i'.\tremil\,  the  Ixxlv  of  the  rib  presents  a  roughened,  soniewhil  -hallow  surfai  e  for 
the  reception  of  the  costal  cirtilage. 

The  t\]mal  ribs  arc  the  third  to  the  tenth,  the  tirNf  two  and  the  la-l  two  c\hibiling  icrtam 
]ieculiaiilies.  The  first  rib  (l''ig.  J^l  is  short  and  bio.id;  it  is  not  placed  \erlic,dl\  but  almost 
hori/ontally,  so  that  an  upjier  and  a  Iowit  surface  m.i.  ..c  reiogni/.ed  in  il-  posi(  rior  portion, 
and  an  ujiper  or  outer  and  a  lower  or  inner  surface  in  its  anterior  jxirtion.  It-  head  has  no 
en -1,  since  the  tirst  rib  usually  arti(  ulale-  with  tbr  Ixxly  of  the  fir-t  tiiorat  ii  \crlebra  only 
and  "o!  wall  two  .uljacent  vertebra',  and  its  angle  loincides  with  the  tulxTcle.  Near  th( 
anleriwr  e\iremil\  of  its  Ixxlv  lliere  is  a  low  rough  protuberance,  known  a-  the  ■H'llim-  luhrnh- 
01  lnhinit  Oj  I.isjriinr,  fur  tlu   in-erlion  of  the  scalenu-  .inlicus  niusile,and  iMliiiid  this  tulMnle 


mt^ 


THE   RIBS. 


33 


there  is  a  broad  shallow  groove,  the  sitbilavian  groove,  for  the  subcla\ian  arttn-,  and  close 
beside  this  groove  a  roughened  surface  for  the  insertion  of  the  scalenus  medius  muscle. 

The  second  rib  (Fig.  25)  resembles  the  first  and,  at  the  same  time,  the  tw.jcal  ribs  a-  \v(il. 
It  is  longer  tlian  the  first  rib,  but  its  posterior  jiortion  shows  the  >ame  [lecuiiar  torsion  of  the 
Ixxiv,  so  that  one  surface  looks  outward  and  u])war(l  while  the  other  is  diretted  downward  and 
inward.  The  position  of  its  anterior  extremity  is  txpical,  an,i  it  posses>(  s  a  capitidar  crest, 
although  the  tubercle  and  angle  still  coincide.  A  roughness,  tin-  tulKidsitv,  scr\is  for  liie  origin 
of  one,  or  sometimes  two  digitations  of  the  serratus  magnus  muscle. 

The  eleventh  I  I'ig.  21))  and  esjiecially  the  twelfth  ribs  (Fig.  ,;o)  an  -liort  and  but  slightly 
curved.  The  crests  of  the  hea<l  are  wanting  and  the  tubercles  ha\e  no  artii  iilar  surfaic,  being 
either  merely  indicated  or  entirely  absent.  The  costal  sulci,  especially  that  of  the  twelfth  rib, 
are  ver}-  indistinct  o'     '      -t  wholly  wanting. 

The  Ijonv  ril)s  i  'n  length  from  the  fir>i  to  tlu'  se\enth  and  tiun  decreaM'  downward 

to  the  twelfth.     The  riljs  present  a  cur\ature  which  mrrc^poniK  to  that  of  the  thoracic 

wall  and  is  known  as  lue  surface  cur\ature.  It  is  only  in  the  la-cs  of  the  first  and  the  posterior 
portion  of  the  second  ribs  that  the  outer  doweri  border  (orres])onds  to  thi'  thora(i(  wall. 

liy  torsidii  runalurr  is  imam  llu'  tor-imi  of  tin-  rilis  ii|'iiii  thrir  a\i  -.  ^  h  li  a  lur^ioti  i-  {■■iiTiil  in  llu  iirM  and  sr.  fitul 
ritK,  sinie  lluv  pax  froni  a  liuii/oiilai  inln  an  uliliiiuc  plane.  Inn  .1  ( irl.iiii  aminini  uf  inr-hm  ,il-n  m(.iii^  in  thi  inidillr 
(ly|>iial)  ril)s  .is  ilu-ir  anurinr  >\lroiniliis  pass  fnini  a  vrrtiral  In  ,in  oliliinic  plani-,  -■>  thai  ilic  ii|ip<r  margin  i-  ■Uniiul 
piisIiTiorlv.  ( )n  tlic  other  hand,  only  the  anterior  (  \tn  niities  of  the  luo  lower  rili~  are  \<  rtii  .1!,  the  posti  rior  l■\lrelnilie^. 
having  their  ui>per  Iwinler  direeted  liackward  ili^;.  j;'. 

The  costal  cartilages  conned  the  bony  ribs  with  the  sternum,  but  it  is  only  in  the  upi)er 
se\-en  ribs  that  the  sternal  connection  is  a  diri-(t  one  iFig.  ,vt).  '['he  eighth,  ninth,  and  tenth 
ribs  ha\e  a  common  cartilage  whitli  is  (imtinuous  with  that  of  tin-  sr\(nth,  anil  the  ele\cnth 
and  twelfth  ribs  ha\e  free  ends  with  short  lartilaginous  apices.  C'onsei)uenily  true  ami  jiihe 
rihs  ma\  be  recognized,  the  true  ribs  being  the  tir^t  to  le  sevinth  and  the  false  ones  the  eighth 
to  the  twelfth.     The  eleventh  and  twelfth  ribs  are  also  ti   ined  /loiiling  r//iv. 

The  ( osial  cartilages  are  Hat,  are  placed  Nirtically  like  'he  ribs,  and  tin  ir  margins  are  rounded, 
posses>ing  neither  grooves  nor  ridges.     Their  length  rapii  i,-  ini  reaMs  from  the  I'lrst  to  tlu'  se\enlh 
and  then  decreases  marked];,',  the  eleventh  and  especial      the  twelfth   ribs  having  merely  car 
tilaginous  apices;    the  first  (ostal  cartilage  i^  also  \(n-  ^l^orl  but  broad.     The  laitilages,  par 
ti(  ularlv  of  the  middle  ribs,  """dme  di>limt''   wider  as  tin  v  pass  toward  the  sii  imim. 

The  tirsi  and  second  cari.lage-'  are  iiu  lined  slighll\  downward  toward  the  sternum  (from 
aNixi  downward  .md  from  without  inward),  the  thini  isc  iitl\  hori/ontal,  and  from  llu'  fourth 
downward  tlu  re  is  an  inireasing  iiK  linalion  from  IkIow  u|iward  anil  from  witiioiit  invvard  (Fig. 
H !.  The  cartilagts  of  the  si\lh  to  the  tenth  ribs  are  often  ipiite  bioad  and  artii  ulate  with  e.u  li 
other  b\  variously  formed  jiroccNses  jias.^ing  upwarl  and  downward;  they  form  s\  in  hoiidroses 
or,  as  is  usuall\  the  tse,  diarihroMs,  and  by  their  union  there  i>  formed  an  arch  like  lowir 
Ijonier  for  the  thorax,  the  (oslal  an  It. 


mt" 


ig^ 


34 


ATLAS   AND   TEXT-BOOK    OF    HIMAX   ANATOMY. 


Fii;.  2g.^Tlie  eleventh  ril)  of  the  ri^ht  side  seen  from  liehind  (j|). 
Fii-..  ;,o.— The  twelfth  rib  of  the  rijjht  side  seen  from  behind  (j). 
Fir..    51.— The  sternum  seen  from  in  front  (J). 
r  ic.  ^2. —  The  xternum  seen  from  the  left  side  (\). 


THE  STERNUM. 

Tlie  breast  bon.,  or  sternum,  is  a  single,  Hat,  oblong  Ixwe.  It  lies  a])proximatelv  in  the 
frontal  jilan',-  and  fonns  the  middle  ].()rtion  of  the  anterior  wall  of  the  thorax,  and  bv  its  articu^ 
lation  with  the  clavicles,  it  ccmi  .letes  the  shoulder  girdle  anteriorly.  It  is  compostxl  (Fig.  31) 
ot  Ihrei.  distinctly  separated  portions  placed  one  aUne  the  other,  an  upper  broad  handle,  the 
nunnibrium,  a  middle  piece,  the  body  or  gladiolus,  anrl  a  lower  jjiece,  the  xiphoid  process.  The 
three  portions  are  either  separated  b\  cartilage  or  are  united  by  tone;  the  former  condition 
prevails  between  the  nianubriimi  and  |l.e  Ixxiy  {syncliomlrosis  stcrnalir),  while  the  latter  ol)tains 
between  the  body  and  the  .\iplioid  process.  .\t  the  synchondrosis  k^tween  the  manubrium  and 
the  l^xiy  there  is  usually  cjuite  an  obtu.se  angle,  o\Kn  [wsteriorly,  the  nni^ulus  slrnii  {aii^i^ir  oj 
Louis).  TW  .sternum  is  not  exactly  in  the  frontal  plane,  but  is  i)lace(l  somewhat  obli.|i  'ly, 
so  that  the  upiier  end  is  considerably  nearer  to  the  vertebral  column  than  the  lower  one,  a  rela- 
tion whi.  h  is  also  partly  due  to  the  curvature  of  the  vertebral  column  isee  jjage  14). 

The  manubrium  is  considerably  broader  than  the  ixxly  of  the  lH)ne,  and  is  broadest  alH)ve 
and  narrowest  below;  its  anterior  surface  is  sli^,;itly  convex,  an.l  the  postirior  surfa.e  slightlv 
concave.  The  upj-er  margin  i^rcsenls  ihree  rounded  notches,  a  median  shallow  inUnlaviaihir 
or  juf^ulur  notdi,  and  two  lateral  deeper  clavicuhir  iioldirs.  which  are  covere<l  with  cartilage 
and  acamimodate  the  sternal  en<ls  of  the  clavicles.  Immediately  i)elow  each  clavicular  notdi 
there  is  a  notch  1  Fig.  ;,2}  upon  the  lateral  margin  of  the  sternum  for  the  reception  of  the  broad 
costal  cartilage  of  the  .,rsl  rib,  whic  h  is  joined  to  the  sternum  in  this  sifialion  by  a  svnchon- 
drosis,  and  each  side  of  the  lower  end  of  the  manubrium  pn  >ent.s  a  demilacet,  for  articulation 
with  the  cartilage  of  the  second  rib. 

The  body  is  usually  narrowest  alnnv,  gradually  widening  as  it  dc^sccnds,  until  it  attains 
its  greatest  breadth  in  its  lower  third,  and  tiien  ra])idly  narrowing  again  as  ii  ai.i>roaciic's  the 
xiphoid  ]iroccss;  it  is  occasion.illy,  however,  of  iiiiilorm  width  throughoul.  Its  nearly  tlat 
anterior  ivenlrali  surface-  i>  called  the  pbiiium  stmuilr,  and  sometimes  presents  transvei-  ■  lines 
(Fig.  :,.\\  which  indicate  the  original  fusion  of  several  parts  situated  one  alx)ve  the  other. 

.\1  the  margins  of  the  lx)dy  i  Fig.  ',j\  are  found  not.  lies  for  the  cartilages  of  the  six  h)wer 
true  ribs,  liiat  for  the  second  rib  Uing  sitiiaied  at  tlu  junc  lion  of  the  manubrium  and  the  Ixxly, 
that  for  the  sixth  nb  .m  the  lower  mai gin  of  the  Ixxly,  and  that  for  the  .seventh  in  the  angle 
Ulween  llie  Innly  and  the  xiphnid  protess.  The  notches  for  the  fifth,  sixth,  and  seventh  libs 
lie  c  lose  logc  the  r,  an.l  the  fourth  note  h  is  situated  Ixlow  the  middle  of  the  entire  Ixme. 

Tl.e  xi/dioid  pronss  varies  greatly  in  shape  and  ^i/.v.     It   is  always  markedly  narrower 

lltroi    ill..    lwwl\-      i.t"r..»*    •...t.d..    ....   r_    ...I,. .11.         .-^.-•1        •  I    •      .  .  -       *  .  .,., 

•"•  i-"^t-   o,  v-.n   •■,!i-,-ii-.   caniiagino-.i:;,  ann  it  is  sonuiin.i  s  julloialed.      1  he 

female  sternum  is  usually  shorter  and  broader  than  that  of  the  male. 


i 


Hv;.  20. 


f-'ij^.   30. 


Iiii;iiliir  iitilih 


( Idviiiiliir 

llOfi/l 


Xiit(/i  fi'i- 
first  r,h 


.\ol(h  lor 
■'iTi'nd  rih 


\olili  lor 
lliirj  nil 


XoU'/l  for 
foiirth  rih 


\  <tii!  for 
fifth  rih 

\otrii  lor 
si\th  rih 

Solch  10. 
^rfOlth   ri 


Manubrium 


Body  of  sternum 


Xiphoid  process 


(  litvinihir  'ii'tih 

\ot(li  lor  tii-sl  rill 
Manubrium 

Xi'lrli   fiir   siioril  rih 


Soliii  for  f/inj  rih 
Body  of  sternum 

.\\<lih  lor  fill  rih  rih 
Xi'Irh  lor  mtli  rih 

Xolih  lor   -.iKl/i  rih 
Xi'lilt  tor  \rvriilii  rih 

Xiphoid  process 


f-if!-    il 


/ik'.    iJ. 


. 


stt-v 


THE   THORAX. 


35 


THE  THORAX. 

The  thorax  (Figs.  32  to  ,^6)  is  formed  In-  the  twelve  thoracic  verte})ra',  thi-  twelve  pairs 
of  ribs,  and  the  sternum,  and  i^  an  approximately  conical  cavitv,  wide  open  alxne  an.l  below, 
and  with  the  ajjcx  directed  ujAvard. 

In  it  there  ma.\  be  recogni/cd  an  iipjier  openin-  and  a  much  lari^cr  lower  one.  The  superior 
thoracic  aperture  is  formed  by  the  first  thoracic  virtebra,  the  first  rib,  and  the  upper  nmn'in 
of  the  manubrium.  Like  the  cross-section  of  the  thorax,  it  is  renilorm  in  shape'  ,on  account 
ot  the  projcctinR  vertebral  lj<xlies),  and  is  placed  not  horixontallv  but  obli.|uelv,  Ixinsr  directe.1 
downward  an.l  forward  so  that  at  the  end  of  expiration,  the  ujij.er  margin  of  thJ  sternum  usualh- 
corresixmds  to  the  junction  of  the  .second  and  third  thoracic  \ertebr;e. 

The  inferior  aj.erture  is  of  very  irregular  form  on  account  of  the  noi  .  situate.l  Ixiween 
the  costal  margins  and  the  lower  end  of  the  sternum.  It  is  Uiunded  posieriorh  bv  the  twelfth 
thoracic  vertebra,  by  the  twelfth  and  then  by  the  ele^cnlh  rib,  and  anteriorh  bv"  the  costal  mar 
Sins  and  the  xiphoid  pr.xe.ss  of  the  stirnum.  The  angle  between  the  coital' margin  and  the 
xiphoid  process  is  known  as  the  .^uhroshi/  or  iiijni'<tcnia/  aiii^lc. 

The  anterior  wall  of  the  thorax,  formed  by  the  sternum  and  the  costal  cartilages  is  con- 
siderably shorter  than  the  posterior  one,  formed  bv  die  vertel,ral  K.lumn.  .\lx)\e  the  difference 
amounts  to  the  height  of  two  entire  ^■ertebra^  while  below  it  is  usuallv  (accor.iing  I.,  the  length 
of  the  xiphoid  pnxess)  n|ual  to  three,  sime  the  lower  end  of  the  xiphoid  process  ordinarily  is 
opix)site  the  ninth  thoracic  vertebra.  The  lateral  wall  formed  bv  the  ribs  is  still  longer  than 
the  ix)sterior  one  1  Fig.  ,^51,  the  lower  margin  of  the  twelfth  rib  extending  downward  to  the  level 
of  the  second  lumbar  vertebra.  On  either  side  of  the  Ixxiies  of  the  vvrtebra,  which  project 
markedly  into  the  thoracic  caviiy,  there  is  a  broad  gr(K)\e,  the  pulmomirx  i^roovc.  The  trans 
verse  or  frontal  diameter  of  the  tlu.rax  is  considerably  larger  than  the  .sagittal  or  sterno 
vertebral  one. 

The  spaces  situated  between  ihe  ribs  are  known  as  the  inUnoshil  spaas,  and  are  ele\en 
m  numIxT,  the  lowermost  one,  that  Ixtween  the  eleventh  and  twelfth  ribs,  being  verv  short 
I  heir  direction  naturally  corresponds  exactly  to  that  of  the  adjacent  ribs,  but  ihev  are  con 
.siderabl;   wider  than  these  structures,  es[)ecially  in  front  Ix^tween  the  cartilages. 

THE  DEVELOPMENT  OF  THE  RIBS  AND  OF  THE  STERNUM. 

Tl,c  osM.ka.i.,n  ,,(  ,lu.  nlK  ,„k,.  ,,l..,.  ,  Liwl.  ,„„„  a  ,.nu.  ulu.l,  .„,,„...  ■„  ,l„.   l,.„ly  ..i  ,i,..  HI,  M.nul.un.ou.lv 
ith  tl..  M-nUTs  „f  Uu.  vcrtelm,..     S,,,,,.  Urn..  ..ft.T  |,ul..T,y  .piphysc-al  ,  .nfr,  .,,,,„.ar  („r  ,lu-  lua,b  an.)  lul,,..  I,..  a„.i 
U„s,   ,l„  n,.l  fusr  uill.  thr  main  |.,,rli.„,  ,,|  ,|;,.  I,,,,,,.  i,n,il  ,„t,.r  il„-  l«,ntv  lilih  ^,„ 

n,r  manubrium,,,-  tl„-  s„.rnun,  i>  usuallv  form,-,|  fn,„,  a  sinnl..  „u.  1.,..,  uhil,   ,1„    U.h  i,  .1,  ^,  I,,,,.  ,1  (ron,  a  „u,„- 
,..r  ,„  m„  1,.,  ,f„ur  L,  IhirU.n.,  uhu  1,  an  (n,|u.  „.l^  arra„K,-,l  in  ,«■„  mor,-  „r  l.-.s  ,l,M,n, ,  l„n«itu.linal  r„«,.    A.  a  rul. 
.lu.r..,sl,u,on..,..n.,.r(„r,h,    xi,h„i,|   ,,r.„,..s.     .  .s.ifi,  a.i.m  „f  ,1,..  sU-rnun,  .l„..  n„,  i„  ,in  un,il  ,lu-  f.,ur.h,„   .iMli 
n,„nlh  „f  ,.ml,ry.,ni,    l,f..,  an,l  in  llu-  .vi,,h„i,|  ,,r„..>s  n.,1  until  fn,m  thr  mmH  ,.,  |I„.   tu,  nli,lh   y,,,r. 

VARIATIONS  IN  THE  SKELETON  OF  THE  TRUNK. 

Su,HTn,un,rar,^UTUl,ra.  a„-  ,„„„.„n„  .  |,r.>.n,.  |,ar,„  u!arl>  ,„  th.  l„„vr  ,„„u ,  ,1„.  v.-n.-hral  u,lumn  Ka,  run, 

urn  ,ar  v.ru  ,r..,,     N,.,  ,nfro|U..n,ly  ril„  ar,-  f„rnu..l   fr„m  .h..  ,,.s.al  ,,r„,...s,.s  ,.(  ,h,   ...  n,l,  ,  ,.r^  i,  al  an,|  ,.f  ,]„.  !  ,.,' 
lumbar  v.Tlrbra-,  an,|  ar,.  .1,  .iKnab.l  a.  .,rvi,al  an,!  knnbar  ribs    r.s,,..  ,iu  Iv.      -11,,.  las,  hunbar  u,,,!,,.,  s,„„,,„„„ 


36 


ATLAS    AND   TEXT-HOOK   OF   HUMAN   ANATOMY. 


p,(,    ,,  _Thc  thorax  toijethcr  with  the  left  shoulder  sirdle,  seen  from  behind  (I). 

p,,.;  :'  _'rhc  thorax  together  with  the  left  shouUler  (girdle,  seen  from  in  front  (>)• 

r,.",t-The  skeleton   of  the  trunk,  divi.led   by  a   medium   lon.itu.lin.l  seefon,  together  w.th  the 

shoulderandpelvicgirdles,  seen  from  the  left  side  (J. 
Fk-,    ,6 -The  skeleton  of   the  trunk,  divided   by  a    median  longitudinal  section,  together  w,th   the 

shoulder  and  jadvic  girdles,  seen  from  tlie  median  line  ^  J. 


a..,,,,  a  „n,.,  n,a.  .,u,  „  .,.uu.  .ii„  iho  ..run,  .,„.  i.  ,„ ,.  r.^ira., . ;; -:;;;;;;^:::;r::;:;,;::r;i;: 

,,,t!,-  ,0)    ;.n.l  t!u-  iK.sUTior  arch  of  ,!«•  atlas  and  the  i-m-ns  rq,rrs.-nUnK  tW  arch, .  ol  tlu 
fail  l/.  ..,.ifv,  s..  that  the  spinal  >anal  nmains  ol-n  postiTicrly  (rhach,.s<h,s..). 

TlK.  ribs  froiucntly  fork  near  th,    ,  „s,.„  hon.lral  articulations,  the  tw,.  ,,.,r„„ns  ..,  (nrnu-a  u.ualh    u■ul■n^  a.a.n, 
^,.  th.it  a  fiiK-slration  of  th-  rib  is  proiluiid.  .    ,    .,  \i  ii,,.  „„n<Ti'n(l  of  the 

tie*  ur. 


THE  SKELt  TON  OF  THE.  HEAD. 


The  .um  total  of  the  l>ones  of  the  head  is  designated  as  the  skull  or  crannm  antl  this  por- 
tion of  tl..  skeleton  differs  front  the  others  in  that  all  of  its  constituents,  with  the  cxccpt.on  of 
the  lower  jaw,  are  llrmlv  united  evt  n  in  the  macerated  con.lition  (the  exact  nature  of  the  union 
is  described  untler  "S;  ndesmology,'^  page  107),  so  that  special  means  are  re<,u.re<l  t«  ^pand. 
the  imiivi-lual  hones  froni  <  a<  h  other,  and  such  a  separation  is  not  usuaUy  successf,^|  tf  he  n  h- 
vklual  is  too  0I.I.     A  skull  the  iK^nes  of  which  have  been  isolate<l,  is  known  as  a  dis.ir.tculatcd 

'''"  The  complelelv  fonnc.l  adult  skull  is  an  extretncly  complicalc.i  structure,  some  of  the 
in.livi.lual  parts  being  unite.l  n,  such  a  ntanner  that  it  is  cpiite  difficult  to  rccogni.e  ihent.  Sonn- 
;  ,  es,  intlcci,  are  scarcely  visible  in  the  perfect  skull,  owing  to  the  fact  th.U  they  are  ^  a  grea 
extent  covere.1  or  overlappe.l  by  the  other  cranial  bones.  Before  describing  the  imhs  dtta 
cr-nial  Ix.nes  it  will  be  a.Uantage.nis  to  consi.kr  briefly  the  skull  as  a  whole,  in  onler  ,0  obtain 
.n'i.lea  of  the  topography  of  the  ntdividual  tranial  lx>nes  and  of  their  chief  corn,K.nent  parts 
The  skull  will  therefore  be  siudie.l  first  front  in  front,  then  front  the  si.le,  from  below  (without 
the  inferior  maxilla,,  ami  from  above,  looking  dt.wnward  upon  the  great  crania  cavitywhich 
.nclo>es  the  brain,  and  hnally  the  outer  and  inner  aspects  of  the  cranial  vault  will  be  consulere.l. 

THE  ANTERIOR  *-3PECT  OF  THE  SKULL. 

If  the  anterior  as-eet  of  the  skull  (l-'igs.  .^7  an.l  ,^S.  be  examine.l,  it  will  be  seen  that  the. 
,.onv  forehead  (/n...  is  formed  by  ihe  vertical  portion  of  the  jnnUal  /,.,„•  art.  1  that  tow.trd  he 
vcrt'ev  a  slightiv  sernite.l  suture,  the  .>ronal  sulurr.  separates  the  vertical  plate  o.  the  Ironta 
from  the  two  panual  ho,us.     The  fron.nl  l».ne  also  forms  the  upper  margin  of  the  ..rl,it,  an.l 


.,/„r   /., 


r  !):!}!:     h\ 


!,>■ 


at  the  outer  margin  of  the  orbit  it  is  separate,!  from  ihe  Contiguous  -v^-<;»;<i/:r  or  Jn--,-..- 
a  suture,  the  --v.^tm./a.  ;..i/./  suU.n:  The  pr.K-ess  of  the  fre.ntal  l.,ne  articulating  with  the 
/.vgomatic  l..ne  in  this  situalio.  is  known  as  the  c.v/cr«./  angular  or  .v,',>m./;<-  V.ccs.s.  o 
either  s,de  of  the  fronlal  lx,ne  will  Ix^  observe<l  the  anterior  inferior  or  sl,l„noulal  an)-lc  of  the' 


a. 


irivical  vrrldtni 
C.lnviili' 


SlTO'h 


nfihriiiiii 


lUivriith  rib  i'-  ' 

ImiJ'lh  rib 
I  irst  lumbar  vertebra 


f'llS.    15 


femur 


S/i//ir  01  i^rhiuin 


Tin:    I.ATKRAI,    ASl'IX'T    OI     THI        kill 

parietal  Ijonr,  which  is  sci)arai. .;  from  tiif  ^rralcr  win-  ..i   ihi     finnoid  lr„u   1>\     ik-  snli,r., 
parietal  siilurr.     A  \»,vvw  of  the  Innporal  hoii,  i>  alx.  \i,-.il)K-  on  0-.   .murior  asi.c(  i  of  tin     kull. 

Be-low  the  \(  n:,  •  ilatc  of  the  frontal  l«)ne  are  ihe  lar-e  o,!,iial  (aviii,-.  ih,  ,t,Mvate-  jH-rtion 
of  whose  roofs  are  toi  nied  bv  the  orbital  plate.>  of  the  frontal  l)on.  .  wlii,  h  arlieulaU  Aith  ili. 
orbital  surface  of  the  ;;reater  win,i,'s  of  the  sphenoids,  ilie  intervi  iiin.4  .,imire  Ik  mu  llu  spli-'w 
jroiilal  siilun:  thev  are  sejiaraied  ironi  the  le>ser  u  iiii,' of  the  spheiiuid-  bv  ih,  sii /,,  rior  orf.ial 
/i.ssiirr  hhnwidal  jissiin).  'IIk'  s>>hniozyoomati<  sitHirr  \>  situated  in  di,  outer  wall  of  ih.  .rbi! 
between  the  .i;reater  whv^  of  llx'  sphenoid  and  the  /y.i^omane  bone,  llu  kitler  formin-  a  part  oi 
the  outer  wall  of  the  orbit,  a,-  well  as  the  outer  r.nd  a  portion  of  die  lower  ni.irtrin  of  di.   orbit. 

I"he  iMMiy  brid>;e  of  ihe  no-.    i>  plaeed  belwetii  the  twoorbiial  ea\ih.  «,  and  in  lhi>  -iiualini. 
the  frontal  lx)ne   artiiulates  on  either  side   widi   ihrei    bones  which.  Irum   within  oulward,  are 
the  nasal  bonv,  the  na^al  or   -noUal  prouss  of  ine  maxilla,  and  llie  l.ulirymal  hour.      Vhv  inter 
venin,^  sutures  are  called  tlu    nasojronlat.  the  ■ixillary.  and  the  jroulohu hrvnial  -utures, 

'I'hi'  two  na^al  Ixmes,  which  form  the  mai  .  ,„,  of  the  lH)nv  brid,m  oi  the  iiom-.  are  .ep 
arated  from  each  other  bv  the  nilrni,i-..i!  Miliir: ,  and  from  the  nasal  proc  c-,-  o|  llie  m.ixill.i  1)\ 
the  iias,niu!.\i/lary  suliirr.  V\\v\  form  ih.'  ui)i)er  Ix.undarv  of  the  anterior  nar,-  la />,  rliira  piri 
/Dniiisi.  which  are  l)ounded  ihrou.i,'liout  the  rest  of  their  c  ircumferc  iicv  b\  the  two  maxill,, . 
These  two  l)one>  are  .separated  in  the  median  line  by  the  iiil,  niutxillaiy  Mitiin\  and  die  frontal 
or  na^al  j)rocess  of  each  is  separated  from  the'  cc)rres|K)ndin,i,'  nasal  Ixmc'  by  the  nasomaxillary 
siitun;  and  Ijorders  externally  ujx.n  the  lachrymal  bom  (for  a  detailed  description  -cv  die  orbital 
ca\ily,  |,a,i,'c  731.  The  maxilla  also  forms  the  inner  half  of  the  llcH)r  of  tlu'  ..ibit  and  .-i  the 
interior  orbital  mar<;i!i,  the  in';, rior  orbital  i.^plirnonuixillarytjissnn.  in  llu  lloor  of  llu'  nrbil 
sejjaratin.i,'  the  maxilla  from  the  ,i;reater  winj;  of  the-  sphenoid. 

Below  the  inferior  orbital  mar.Liin,  in  the  body  of  the  maxilla,  is  i!,,'  injranrhital  joramni. 
and  in  the  anterior  nares  can  be  seen  the  lx)n\-  nasal  septum*  and  also  ih,-  „„>„/  naidia  Uurbin 
aled  hones),  particularly  the  inferior  ones,  which  jiroject  from  the  outer  wall  of  ih,-  nas.il  fe,ss.,. 
.\t  die  junction  of  the  intermaxillary  suture  with  the  lower  m.-ii^'ins  of  the  anterior  narcs  ,h,iv 
is  a  bony  siiine.  the  anterior  nasal  ■^piiie.  The  :yi^oniaiieoinaxiii,!ry  suture  separate  s  tin-  maxilla 
trom  the  /yijomalie  Ixine,  who.se  malar  irface  is  xisibl,  i-f  the-  anteri.ir  \iew  o|  the  skull.  Tin 
I'lwer  portion  of  the  maxilla  forms  the  loolh  luaiint,'  aiveotar  proei  ss. 

Finallv  there-  is  the  maii.lihle  ,,r  lowe  r  jaw.      lis  middle  p,>rti..n  or  1xhI\  pn.sents  a  loranien. 
the-  mental  joramen,  an.l  the-  in,,th  bc-arin-  alv,olar  f>oriion:    lot-ithei-  si,lc  (and  s^meuh.il  fore- 
shortened in  the-  liijurci  ihe  ramus. 


THE  LATERAL  ASPECT  OF  THE  SKLTLL. 

The  kiteral  aspect  of  the  skull  :  id.^s.  ;;(,  and  .\o<  ccniains  a  number  of  bones  uhi,  h  ha\e- 
been  idrcady  ecinsidered  in  ihe-  description  of  the  anterior  cranial  ic-ion.  .\bo\.  uid  anierioriv 
we  observe  that  the  frontal  bone-  is  separalc^d  from  the  p.iri  l  d  bone-  bv  tin-  eoro,;.i!  uilure.  and 
from  tnc  jjreater  wmir  of  i->  sphenoid  b\  llu-  sphenoironlal  :,!ure.  The  :\\:;om.:!ieojrontal 
iulure  separates   the  /},<,'onia!ic  jirocc-ss  of  the    frontal    boiu   from   du    jronlosph,  noidal  proeess 


*  Ml 


e   .iiilcrii.i  |"irtiii;i  ,,f  tin-  n.is.il  M  |iiuni 


artiln).'iiiou.T. 


38 


ATLAS    AND    TEXT-BOOK   OF    HUMAN    ANATOMY. 


m 

•i 


of  the  zygomatic  bone,  and  the  temporal  ridge  commences  at  the  zygomatic  process  of  the  frontal 
bone  and  passes  backward  in  a  curved  manner  over  the  frontal  and  parietal  bones. 

Behind  the  frontal  bone  is  seen  almost  the  entire  parietal  lx)ne.  It  is  limited  anteriorly 
by  the  coronal  suture  and  is  separated  from  the  occipital  bone  ])osteri()rly  by  the  lambdoid  suture. 
Its  lower  border  articulates  with  the  greater  wing  of  the  sphenoid  by  the  s plieno parietal  suture, 
wuh  ii.e  squamous  portion  of  the  temjwral  Inme  by  the  squamosal  suture,  and  with  the  mastoid 
jwrtion  of  the  temjwral  lx)ne  by  the  parietomastoid  suture. 

The  only  inirlion  of  the  oecipital  bone  visible  in  the  lateral  view  of  the  skull  is  its  squamous 
portion,  which  is  se!>arated  from  the  mastoid  prtxess  of  the  temjxjral  lx)ne  by  the  occipitomastoid 
suture. 

Below  the  frontal  and  parietal  lx)nes,  the  temporal  surface  of  the  greater  wing  of  the  sphenoid 
is  visible.  It  is  separated  from  the  zygomatic  lx)ne  anteriorly  by  the  sphenozygomatic  suture, 
and  from  the  s(iuamous  jxjrtion  of  the  temporal  Ixme  [wsteriorly  by  the  splienosquaiiuisal  suture. 
The  first  jwrtion  of  the  temporal  bone  to  attract  attention  in  the  lateral  a.spect  of  the  skull 
is  the  s<iuamous  [wrtion,  from  which  a  long  jjrocess,  the  zygomatic  process,  i)asses  almost  hori- 
zontally forward  to  arti(  ulate  with  the  short  temiwral  pnKes.s  of  the  zygomatic  lx)ne  by  the 
zygomaticotemporal  suture;  the  two  j)r(Kes.ses  together  forming  the  zygoma  or  zygomatic  arch. 
The  origin  of  the  zygomatic  pnxess  of  the  temjxjral  Ijone  marks  the  termination  of  the  inferior 
tem{)oral  line  as  it  |)asses  from  the  parietal  to  the  lem|M)ral  lx)ne. 

Below  the  inferior  tem]K)ral  line  there  is  upon  the  lateral  surface  of  tlir  skull  a  slightly 
depres.scd  area,  the  planum  temporale,  fomied  by  the  tem|K)ral  and  parietal  lx)nes,  the  greater 
wing  of  the  sphenoiil,  and  a  smalt  jxjrtion  of  the  frontal  Ixme.  In  tin  zygomatic  region  the 
planum  temporale  deej)ens  into  the  temporal  fossa. 

The  portion  of  the  temporal  line  situated  ujHin  the  temporal  Ixme  forms  ai)proximalely 
the  anterior  Ixmndan,  of  a  second  jMirlion  of  the  tem|K)ral  tx)ne  visible  in  the  lateral  view  of 
the  skull,  the  mastoid  portion,  which  derives  its  name  from  a  Ntrong  conical  prolulierance,  the 
mastoid  process. 

.\  third  jKirtion  of  the  tcmi^ral  Ixme  to  Ix'  seen  in  the  lateral  cranial  rigion  is  the  tympanic 
portion,  and  is  situated  inunediately  Ixiow  the  r(H)i  of  the  /\goma,  forming  the  outer  and  lower 
circumference  of  the  large  ojjening  of  the  Ixmy  external  auditory  meatus  (meatus  acusticus 
externus}. 

In  hxiking  at  the  skull  from  the  side,  the  malar  surface  of  the  zygomatic  Ixme  is  directed 
toward  the  observer.  In  the  lateral  asi)ecl  of  the  maxilla  thiri'  may  be  obscrwd  (as  in  the 
anterior  view  )  the  anterior  nas;tl  spine,  the  frontal  pnxes.>,  the  nasomaxillary  suture  by  which  it 
articulates  with  the  nasiil  lK>nes,  and  the  alveolar  jirwess,  whiih  is  vi'reele<l  toward  the  simi 
larly  named  iKjrtion  of  the  mandiijie. 

In  the  lower  jaw  we  see  thi'  Ixnly  with  ilu  mental  foramen,  and  almost  at  right  angles  with 
the  Ixnly,  tlu  ranui>,  the  upper  portion  of  which  is  divided  by  a  derp  notch,  the  sigmoid  notch, 
intn  two  imxessi'S,  the  coronoid  and  the  condyloid  pr<Kes>es.  The  articular  surface  of  the 
(ondvloid  prmess  rests  in  a  lo.->sa  of  the  temjxiral  Ixme  situated  Ixlow  the  riK)t  of  the  /ygoma, 
ihc  nuvniibuiar  or  glenoid  jcc.sa. 


S^Sli 


:-JH        I 


,!<» 


//X'.    t7. 


nasal  process  of  maxilla 

lachrymomaxillarv  suliirr 
sphenofror.tal  suture 
supriiorhilal  margin 


internasJ               ^'"■<""'' 

suture                    •"'""•'' 

nasofrontal  suture 

^^\                        '^^^ 

S*, 

Jrontomuxillary  suture 

', 

/^ 

5v 

orbital  surface 

\                'j 

^\. 

of  orbital  plate 

\frontal  bone 
(vertical  plate) 

/ 

'^W 

of  frontal  bone 

^ 

^ 

\       \                              / 

.  ;/ 

/ 

\ 

lachrymal  bone 

\      \      \ 

/'* 

/■'-' 

4\  ■ 

sphenofrontal 

\ '    \ 

■■/; 

/■  -^'-i 

f/M 

suture 

\      \ 

■J 

\Mk 

sphenoparietal 

/ 

Ip+'Jl 

suture 

parietal  bone 

<  ^pheniyidal  tingU  > 

Sirfatfr 
u'int;  fl/ fphennii/       ,., 
/tt'm/wral  surface  > 

zygomatic  process  I" 

orbital  plate  of  ^- 

frontal  bone  \ 
sphenoidal  fissure 


h 


•eater  wlf 
^  sphettoid 


\    jfyeontafi 

i'.     bone 


sphenomaxillary     \ 
fissure 


infraorbital  marsrin 

nasal  bone 
nasal  septum 


alveolar  process 
of  superior  maxilla 


anterior  nasal  spine 


if 


nuxrlla  I 


-Vf^ 


r 


rr 


i  I  >; 


V, 


mandible 
(body) 


Fig.  3S. 


,'/'. 


temporal  bone 


zyiromatico-frontiil 
Z' "•••/.  \    i  suture 

sphcnozyiioniatic 
suture 

nasomaxillary 
suture 


zyi^omatico- 

maxillury 

suture 

infniorbifiil  foramen 

ramus  of  mandible 
inferior  tiirhinalcd  hone 


>.j 


mental  foramen 
iutcrmn  miliary  suture 


Ki^s.  .<7  aiul  .Vs.     The  -kul'   sofii   trtim  in   trmU   ('-). 
In    tl^.  .*^    the    tVontiil    liono    i-*    vi^ilct.    tlic    rTi;i\ill.'i    \i'lln\\.    the  splirtmicl  ^rci'n.    tin-    p.uirtJiK 
lirnwii.  Ihf   laclii' nials    .uul    \iinui     pink,   tlu'  ctliniDiil  (Mannc   thi'   /xgoniatii'  pin'    stri'nkid.   tin-  nwindilili' 
i/liii'    !il(i-ttki-ti   ami    ilie    tia>di*i    una    Itiiipoi  .ii<«    while. 


i 


r      c 

_     "^ 


it    = 


is       ^ 


h. 


"m^ 


1 


iMHI 


THK   F.XTERXAL   SURFACE   OF   THE   BASE   OF   THE   SKIM.. 


39 


THE  EXTERNAL  SURFACE  OF  THE  BASE  OF  THE  SKULL. 

The  inferior  asjjcct  of  the  human  skull,  exposed  by  the  removal  of  tlie  lower  jaw,  jiresents 
an  extremely  irregular  surface  (Fi>,'s.  41  and  42),  and  is  termed  the  external  surface  of  the  ba.se 
of  the  skull,  basi:>  cranii  externa,  to  distinguish  it  from  the  internal  surface  which  forms  the 
floor  of  the  cranial  cavity. 

Passing  from  before  backward,  there  may  be  noticed  first  the  bony  [ilate  of  the  hard  palate, 
\.hich  is  Iwundcd  externally  by  the  alveolar  process  of  the  maxilla  and  the  upper  row  of  teeth. 
It  forms  the  bonv  ]  '  lition  separating  the  oral  and  nasal  cavities,  is  lomposcd  of  two  bones 
upon  either  side,  the  pnlaliiie  process  of  the  maxilla,  forming'  its  anterior  two  thirds  to  three 
quarters,  while  the  j)OSterior  third  or  fourth  is  furnished  by  the  horizontal  portion  of  the  ])alate 
Ijone.  It  is  trawrsed  in  the  median  line  by  the  median  palatine  suture,  the  anterior  extremity 
of  which  contains  the  incisive  joramen,  a  pit  like  depression,  which  leads  to  a  canal  of  the  same 
name.  The  palate  lx)nes  are  sejjarated  from  the  y)alatine  processes  of  the  maxilla  by  the  trans 
verse  palatine  suture,  and  at  the  posterior  extremity  of  the  median  jjalaline  suture,  the  two  lK)nes 
terminate  in  a  sjjine,  tlie  posterior  nasal  spine.  The  posterior  free  margins  of  the  horizontal 
plates  of  the  palate  bones  form  the  lowc  r  lx)undar\-  of  the  jjosterior  nares  or  riioanir.  the  i)OS- 
terior  outlets  of  the  Ixiny  nasal  foss;e. 

To  the  outer  side  of  the  hard  palate  is  seen  the  short,  broad  zyi^oniatic  process  of  the  maxilla, 
which  articulates  with  the  malar  Umv  by  means  of  the  zyi^omaticomaxillary  suture.  There  is 
also  to  be  seen  tlie  anterior  extremity  of  the  injerior  orbital  or  si)henoniaxillary  lissure  between 
the  upi)er  jaw  and  the  greater  wing  of  the  s])henoid  l;one.  The  zygomatic  arch,  fornud  b\  the 
junction  of  the  zvf^omalic  process  •  f  the  temjioral  l.x)ne  with  the  temporal  process  oi  the  zygo 
matic  Ijone,  is  distinctly  visible. 

A  large  portion  of  tlie  external  surface  of  the  ba.se  of  the  sk'.dl  is  formed  by  the  splienoiil 
bone.  The  greater  wings  are  almost  entirely  visible  and  are  limited  posteriorly  and  externally  by 
the  sphenosquamosal  suture,  their  foreshortened  temporal  surfaces,  already  noticed  in  the  lateral 
view  of  the  skull,  being  seen  to  unite  with  the  infratemporal  surfaces,which  are  actually  situated 
in  the  base  of  the  skull,  at  a  distinct  angle  marked  by  a  rough  ridge,  the  injratemporal  crest. 

The  posterior  margin  of  this  infratemi.oral  surface  is  separated  from  the  contiguous  i)etroiis 
l)ortion  of  the  temporal  l)one  by  the  sphenopetrosal  fissure,  whi(  h  is  lontiniious  internally  with 
an  irregular  foramen,  the  joramen  lacerum.  The  extreme  postiro  external  angle  of  the  greater 
wing  of  the  sphenoid,  the  spine,  is  (lireel>'d  toward  the  temporal  Ixme,  and  preseiUs  a  round 
opening,  the  joramen  spiiiosum,  whicii  leads  into  the  cranial  cavity  and  transmits  the  middle 
nieningeMJ  arlerv.  In  front  of  this  is  a  larger  oval  aperture,  llie  joramen  muile,  tinough  whieii 
the  mandibular  division  of  thi'  trigeminal  nerve  emerges  from  the  cranial  cavity. 

In  the  middle  of  the  base  of  the  skull  a  -lait  of  tin  Ixxly  of  the  sphenoid  U>ne  is  visible 
between  the  two  greater  wing>,  but  itsanteri  lortion  is  jiartly  concealed.  It  will  I h- observed 
that  the  |)o,sterior  margin  of  the  bony  r  d  ..ejitum,  which  in  this  jirejiaration  repres  Us  the 
septum  choanoruiii,  is  forme<l  f)v  the  von.  r,  which  articulates  with  the  Ijody  of  the  sphenoid 
')y  nitans  of  a  broad  basi',  known  as  the  ala  vomeris. 

.\  .strong  process,  the  pteryf^oid  process,  which  is  divided  lengthwise  into  two  jilates,  projects 


I' 


I 


40 


ATI.AS    AND   TEXT-BOOK    OF    HUMAN   ANATOMY. 


downward  from  the  bofly  of  the  sphenoid.  The  broader,  larger,  external  plate  is  termed  the 
exleriml  pteryf^oid  plate,  and  the  narrower  internal  one,  the  inlcrnal  plcryt^oid  plate,  terminates 
below  in  a  small  h(x)k-like  process,  the  hanmhr  process  {hamulus  pterygoideus).  The  pten,-jToi(l 
process  of  the  sphenoid  lx)ne  articulates  in  this  situation  with  the  horizontal  plate  of  the  palate 
Ixjne  and  also  with  a  prcxess  of  this  lx>ne,  its  tuberosity  : processus  pvramidalis),  which  is  dirccterl 
backward  and  outward  and  fills  the  gap  Ix'tween  the  external  and  internal  pterygoid  plates, 
consequently  aiding  in  the  formation  of  the  pterygoid  jossa,  which  occui)ies  the  inte'rval  between 
the  two  plates. 

In  the  j)alate  lx)ne,  at  its  junction  with  the  pterygoid  |)r(.cess  of  the  sphenoid,  there  is  a 
larger  anterior  foramen,  the  (-realer  palatine  joramen,  and  usually  se\eral  smaller  posterior 
oi)enings,  the  lesser  palatine  foramina. 

The  iK)sterior  half  of  the  external  sur.ace  of  the  base  of  the  skull  is  formed  by  the  two  tem- 
poral bones  and  by  the  occipital  lx)ne.  .Ml  the  four  portions  of  which  the  temiK)rai  Iwne  is 
comjiosed  are  \isiljle,  naniel\-,  the  inferior  surfaces  of  the  petrous  portion,  of  the  mastoid  portion, 
and  of  the  tympanic  portion,  and  a  |)art  of  the  squamous  portion.  The  apex  of  the  petrous 
portion  lies  in  an  irregularly  shajied  opening,  the  ioramen  laeerum:  it  is  se[)arated  from  the 
sphenoid  bone  anteriorly  by  the  sphenopetrosal  fissure  and  from  the  ...cipital  Iwne  posteriorly 
by  the  pctro-occipilal  fissure.  The  mai,toid  jx.rtiim  articulates  with  the  occiiiital  Ijfjne  b\  mean's 
oi  the  occipitomastoid  suture. 

Of  the  >(|uamous  portion,  one  sees  mainly  the  zygomatic  process  (forming  a  jjortion  of  the 
zygomatic  arch)  and  the  mandibular  jossa,  which  accommwiatcs  the  condyloid  i)rocess  of  the 
mandible  and  presents  anteriorly  the  articular  eminence.  Of  the  mastoid' portion,  there  is  to 
lie  sen  the  mastoid  process  {processus  ma.Uoideus),  which  has  a  deep  gr(«)\-e,  the  digastric  fos.sa 
(inci.sura  mastoidea),  upon  its  inner  surface,  and.  at  the  side  of  the  oci  ipitomasloid  suture,  an 
op.'ning,  the  mastoid  joramen.  The  tNinpanic  portion,  with  the  meatus  audilorius  exiernus, 
is  placed  Ix'tween  the  m;Lstoid  procTss  an<I  the  mandibular  fos>;i,  and  in  front  of  it  there  is  a' 
fissure,  the  (ilaserian  fissure  (fissura  petrotympanica). 

Th.Te  are  many  foiunn'na  and  fossa-  uix)n  the  ven,-  rough  and  irregular  lower  surface  of 
the  petrous  portion  of  the  temp(,nii  Ixme.  Slightly  to  tiie  inner  si.le  and  in  front  of  the  mastoid 
process  is  111,'  pointed  styloid  process,  between  the  mastoid  and  styloid  processes  there  is  ;;n 
oi)ening.  tii<  stylonuistoid  Inramcn;  to  t],e  inner  si.le  of  the  styloid  process  there  is  a  radier  iWxu 
dei.ression,  the  jugular  jossa,  leading  into  th,'  iraniai  cavilv  through  an  irregular  opining,  the 
juf^ular  joramen;  and  to  the  inner  side  and  in  front  of  ilie  jugular  fossji  there  is  a  round  opening, 
the  external  orilire  of  the  uirniid  canal. 

Thr  occipital  hone  forms  the  large  remaining  i«.rtion  of  the  external  surface  vi  the  i)asc  of 
the  skull.  In  the  adult  s,<ull  it  is  unitol  with  the  sph.'noid  so  that  its  basilar  portion  is  continu.ais 
.anteriorly  uilh.  ihr  bo,ly  of  th-  sphenoid  lione  without  demanation.  Posteriorly  the  basilar 
portion  forms  the  anterior  margin  of  the  joramen  mof^num,  whilr  ihc  portions  of  bone  external 
to  this  foramen,  known  as  the  laliral  portions^  pres.^nt  ih,'  two  large  occipital  condyles,  by  means 
ot  which  the  skull  articulales  with  the  lirst  ceryi.;il  yerir!,r.:i  ,,.•  aiLi-.  Tl!..  hjisf  of  .■:!!  h  eo.ndvlc 
is  perforated  by  a  short  (anal,  the  hypoglossal  or  anterior  condyloid  ,onal,  while  the  termination 
of  a  similar  canal,  the  condyloid  or  posterior  condyloid,  is  \isible  behind  the  condyle. 


Fit;.  41. 


i^fs^i'^v^r 


aid  YPineris 


horizonlnl  portion  of  /lalan 
ho"(' . 
himtidl  /ili-n-t;oiil  /tloif: 


zvnomalic  horir  llcmpori:!  •.urjnn') 
ixtcriiiil  ptiiyiioiil  I'lotr  ■ 


infratemponil  surface  oj 
gmilfr  wing  ol  sphenoid  ' 


sphenoparietal  suture 
nrliiiiiiir  eniiuenee  - 

fonimai  spiiiosiim 
jonimcii  /anriim  ■ 

orifice  of  eiirotiil  ennui  -  - 
-H'lomastind  foramen     ''  , 


incisive  t'onimrii 

'•''^  ^  meditin  inihiliiie  suture 

'4     \  .,■  •  ■/Hi/titi/ir  iinxrss  ol'  •di/urior 

innxillii 

iran^verse  palatine   .uluie 
■Kviiomanc  process  of  maxilla 
zvnomatieo-maxiilarv  suture 
po^tirior  nw-al  ••pine 


ZVjroilllltic  (trcli 

infraienipoiul  er  '^t 
Sfdu  nosquaniOMi!  suture 

niutieole-npoial 
suture 

foriimin  ovale 

•.phenoiielro^ul  lt^>nre 
prohe  in  hypoglossal  ennui 
petrooeeipitui  fi^sitre 

styloid  /iroeess 


jllgllhll   fossil    '; 


mastoid  j^roove 

mastoid  foramen  ■' 

occipital  cond'Je 

londyloid  fossa 
foivmen  imiamiiii 


portion         t^non     r  TF-<J.  .  .     /;     i      eMemal  nnilih'iv  nieulns 

oeeipilonni^loui  ^nln>e 

mastoid  /iivccss 


■tornU't,':<l  ^nli.ee 


CxtefiKil  occinilal  /iroliilH'ranee 

ffer.  42. 


inferior  niicliul  line 
superior  niehal  line 


I'i^rs.   41    ami  42.     'I'ln'   -knll   >c>'n   tron 

1,   .isr.   4:  Ihr   vari..u.  I.."irs  are   r,,!,,,-...!   as  in  tif;.   i''  .'xrHit  li.at   tl,.^   ■  ■  npitai   .-> 
uilli   lid  ami  the   luilaliiif-   are  bliiL-. 


1   lu'liiw.   tlu'   uulor   -url.iw   uf  ihr   huso   1  '   , ). 


m 


cribriform 

ethmoidal  spine   //taie 


fr  ■^■iten  caecum 


jiigiim  ethmoidale 
optic  groove   ^• 


^i-ita  gain 

.    fronto-ethmoidal  suture 

sulci  arterios! 

olivary  eminence 


optic  foramen 

anterior  clinoid 
process 

fonimen  rotiindum 
sulcus  arteriosus     t 
foramen  ovale 

fonimen  spinosiim 

trigeminal  impression 

inrmiiil  Mulitory  meatus 

jugular  foramen 

Orilerwr  com/mrlmeiit) 

lambdoid  suture 


jugular  tuhercle 


..,,.„     ,„,„■:       nunwi         hvpOglOSSa!     Ult'l! 

remains  of  the  spheno-nrnpital  su:.ire  ^^,.,,,„„;  ,„•„/«/"/ 
synchondrosis  ,r.  i     nrouihe 

ranee 


Fi:.  43. 

l-ias.    U^  und  41      Th.  inner  -urhu  -  •' 

l„  li".   4'.  the    •.ari..us  1^    ^>es  an 


ihe  bav 

otl  a>  in  I 


sphenofrontal  suture 

dorsum   -ellae 

coronal  suture 

carotid  groove 

siiiunoparktal  suture 
^/•henosquamosa/  ^utuir 

foramen  lacerum 
squamosal  suture 

mlirior  I'l    •■■fill  iinwrf 
pttro-OfCipitii'  ''*' 

hiatus  lulhpii 

jugular  joi       . " 

sigmoid     -oove 
rondyloii:  cunat 

mastoid  •i-iimen 
transvtKe  g     ■>■'<' 


4 


!'f 


!  »: 


THK  INTERNAL  SURFACE  OF  THE  BASE  OF  THE  SKII-I.. 


41 


There  is  further  to  Ix."  ()l)served  the  entire  nuchal  surface  {planum  niuhale)  of  the  squamous 
l)ortion  and  r.  foreshortened  portion  of  tlie  planum  oiripilalc,  the  lx)undary  Ixtween  'le  two 
portions  Ixing  formed  by  a  rough  line,  the  suprrior  nuchal,  which  extends  laterally  from  the 
central  rxlirnal  orcipital  protuberance.  Below  the  upi)cr  line,  the  nuchal  surface  is  crossed  by 
the  injcrior  nuchal  line. 


THE  INTERNAL  SURFACE  OF  THE  BASE  OF  THE  SKULL. 

By  the  interna!  urface  of  the  base  of  the  skull  (Figs.  43  and  44)  is  understood  the  lloor 
of  the  cranial  cavit\-  which  is  expose!  by  sawing  horizontally  througli  tlie  !x)nv  cranium  and 
removing  llie  ealvariuni.  It  is  (<)nca\( ,  and  contains  the  so  tailed  cranial  fossa-,  of  which  llii  n- 
are  recogni/.ed  ar.  anicrior,  a  ntidillc,  and  a  poslcriiir  jossa  (Fig.  4.;i.  All  tliree  fos>a'  n-,eil  in 
a  saddle  like  elevation,  the  sella  lureiai,  which  is  a  portion  of  the  Ixxly  of  the  sphenoid  Ixme  and 
is  situated  somewhat  anteriorly  to  the  middle  of  the  cranial  cavity. 

The  anterior  cranial  fossa  is  relaiively  tlat.  The  greater  portion  of  ii>  tloor  is  formed 
by  the  orbital  jjlates  of  the  frontal  bone  (Figs.  4;,  and  44),  whose  Upper  surfaces  are  dirccled 
toward  the  cranial  ca\ity  and  are  known  as  the  cerebral  surjaa's.  They  ])risent  peculiar  eleva 
tions  and  corresixmding  dtpressions,  called  n>pei  lively  cenbral  lUi^a  an<l  dii^ilale  impressions, 
and  they  also  present  gr(M)ve>  for  IjIikmI  vessels.  The  two  halves  of  the  fnml.il  bone  an-  .~e])a 
rate<l  anteriorly  b\  a  ridge,  the  jronlal  cresi,  which  (omnienci  ^  at  a  foranii  i\,  du  jorameii  arcum. 
and  posteriorly  the  orbital  ])lates  of  tiie  frontal  bone  articulate  with  the  li^xr  wing>  of  tlie 
s]ihenoid  b\  the  sphenojrontal  sulure. 

Lving  Ixtween  the  two  orbital  plates  of  the  frontal  l)one  and  txtmding  from  the  foramen 
ca'cuni  to  the  sjihenoid  Ume  there  is  a  thin  Ixmy  plate,  ( liaraiteri/.ed  by  Uini;  ])erf()rated  by 
numerous  forandna.  It  i^  the  cribrijorm  plate  of  the  ellimoid  bone,  and  it  ])resenl>  in  its  nudian 
line  a  (ond)  like  t  livation,  the  rrisl<i  j^alli,  and  articulates  with  the  frontal  Ixnn  by  mean>  nf  the 
jronto  ethmoidal  suture. 

In  the  niedi.in  line  behinil  tlu  1  ribriform  plate  ni  the  ethmoid  is  ^een  the  iu;.;uiii  ^phenoidali 
of  the  sphenoid  iione  witii  tile  ethmoidal  ^pine,  ami  to  (ilher  side  arr  ob^erved  tin-  lesser  :ci)ii;\ 
of  the  lx>ne.  tin  se  laltt  r  ari-ing  from  eitlur  side  of  the  Ixxly  of  the  sphenoid  bv  two  nxtis  whidi 
ei.dosc  an  o])eniiig,  tlie  opiii  joraiiiiii.  Xe.ii-  the  mII.i  turdca,  the  Iomt  win-;  of  either  side 
proic(  t>  nilo  the  middle  uribr.  I  I'd^si  a,>  a  -hurl,  ^lighlly  curved,  hixik  like  pnKe»,  thi  anterior 
tlinoid  proiiw. 

Tile  middle  cranial  fossa  i>  mui  h  deeper  , and  larger  th.m  \h<  anterior  om,  and  i- divided 
into  two  halvi>  by  a  marked  meilian  elevation,  the  sella  tuntm.  In  ihi-  tliere  may  1k'  re(og 
ni/.ed  tin  lii'.;li  back  of  the  saddle,  tlie  dorsum  ulhr.  with  tin  hypophyseal  jossa  in  front  of 
it,  and, -till  fiirtlur  anleiiorlv ,  the  olivary  imineme  \iuher<  uliim  srllo  ).  In  iron!  >n  ihi  lallti 
i>  a  grixive,  the  optie  ^romr  1  \ulius  i  hia\matis  1,  and  a  M(ond  gnxivc ,  the  larotid  i^ro<ne,  i■^  >i!natecl 
on  each  side  of  the  sella  tunica.  .\  >hort  distance  tx  hind  the  dorMim  sella-  \\i  find  the  spin  no- 
•    ;/>.'*  i'    xf  '1    •<-■••■ Kir'ii! "I'-t!  '••••    ..1.^1.  :...i.    .1,.^.  ii..    !„.,... .Ill',    i,..i,....  I,  ill.,  luwiv 

of  the  Sphenoid  anil  the  otiipilal  Ixme  and  i>  the  remain^  of  the  -viu  hoii<iro-i->  originalh  s(  jiaral 
ing  the  two  lx)ne-.  (>ee  page  4;  1. 


r  i 


42 


ATLAS   AND   TEXT  BOOK   OF   HUMAN    ANATOMY. 


To  the  outer  side  of  the  sella  turcica  we  sec  the  cerebral  surface  of  the  greater  wing  of  the 
sphenoid  bone,  which  is  sejjarated  from  the  overhing  lesser  wing  of  the  s])henoid  by  the  superior 
orbital  or  sphenoidal  fissure.  The  remaining  boundaries  of  this  surface  are  the  same  as  those 
seen  on  the  external  surface  of  the  base  of  th.'  skull,  namely,  the  sphenoparietal  and  spheno- 
squamosal  sutures,  the  foramen  lacerum  or  sphenopetrosal  fissure.  \ear  its  origin  from  thi' 
Ixxly,  the  greater  wing  of  the  sphenoid  bone  contains  three  orifices;   the  joramen  rotundum, 


Kl.i.   45  -Tl..-  iiiii.  I  «»rfa<r  ..f  ihr  l,,is,  i.f  Ihf  skull;  ihr  ani.  rinr  (.«.a  is  (oluml  l.lur,  Ihf  mi.l.llo  f.«.a  «hil.',  ,in.|  tlu- 

|«i«liTior  fc~>.a  pink. 

directed  obli(|iuK  antirjo.lvand  leading  int..  a  short  canal,  the /oram/«  mw/c,  and  the  joranun 
spinosum. 

In  addition  to  the  greater  wing  of  the  sphenoid  bone,  the  n(H)r  of  the  middle  cranial  fossa 
•>.  .nrmc!.  .!y  !.•:•  <!■-<•, sr;!l  --rirfarc  of  the  squamour.  poriinn  ;)[  thr  timjM)i,iJ  ix.iic  iiiid  in  the  an 
terior  surfa(  e  of  the  petrous  iK)rli()n,  the  posterior  surface  of  the  |)etmus  |)ortion  and  the  mastoid 
ixmion  helping  to  form  the  ll<H.r  of  the  posterior  ( ranial  fossa.     The  bcnindnries  of  the  tem|K>ral 


»l 


THE  INTERNAL  SURFACE  OF  THE  BASE  OF  THE  SKUI.I.. 


43 


bone  in  the  middle  fossa  are  also  similar  to  those  observed  upon  the  external  surface  of  the  base 
of  the  skull,  namely,  the  s plicnosquamcsal  and  squamosal  sutures  and  the  joramcn  larrrum. 

U[Xin  the  cerebral  surface  of  the  squamous  portion  of  the  temj)oral,  commencing;  at  the 
foramen  spinosum.  there  is  a  groove,  the  suku.-<  arlcriosus,  which  is  continued  by  manifold  rami- 
I'lcations  uj)on  the  inner  surface  of  the  cranial  vauli.  UjOTn  the  apex  of  the  ))etrous  portion, 
which  is  in  contact  with  the  body  of  the  sphenoid,  there  is  a  shallow  depression,  the  Irii^nniiiiil 
impnssion  for  the  Gasserian  ganglion,  and  at  atjout  the  middle  of  its  anterior  >urfaie  there 
is  a  slil-like  opening,  the  hiatus  canalis  jacialis  (hiatus  Fallopii),  while  u])on  it>  su|)erior  margin 
there  runs  a  shallow  groo\e,  the  superior  petrosal  j^roove. 

The  posterior  cranial  fossa  is  the  largest  of  all.  Its  n(V)r  is  formed  by  only  the  (Kcpital 
and  temi)oral  lx)nes,  the  lioundaries  between  which  in  the  jxisterior  fossa  are  the  pelro-occipital 
fissure,  the  juf^ular  joramen,  and  the  occipitomastoid  suture. 

Upon  the  [KJSterior  surface  of  the  i)etrous  ])ortion  of  the  temporal  bone  there  is  a  large, 
round,  irregular  opening,  the  internal  auditory  meatus  {porus  uustieus  internus). 

The  jugular  joramen,  situated  between  the  temjmral  and  occipital  lx)nes,  is  formed  in  tiic 
following  manner.     Each  of  the  two  l)ones  possesse.->  a  corresponding  notch  which  is  so  sub 
divided  that  the  jugular  foramen  consists  of  a  smaller  anterior  and  of  a  larger  posterior  com 
partment,    the    former   giving    passage    to   the   glosso-i)haryngeal,    pneumogastric,  and  spinal 
accessor)-  nerves;  the  latter  to  the  internal  jugular  vein. 

In  tile  iM)sterior  foss;i  the  mastoid  (mrtion  of  the  temporal  l>one  exhibits  a  curN-.tl  groove, 
the  sit^moid  j^roo^'e,  which  begins  at  the  posterior  com()artment  of  tht  jugular  foramen  and  is 
at  first  situated  on  the  lateral  portion  of  the  occipital  bone,  passing  in  a  curve  around  the 
jujiular  process,  which  is  directed  toward  the  temporal  Ixine.  In  the  mastoid  portion  of  tlu 
tem|)oral  lione  is  thv  inner  (cerebral)  orifice  of  tlie  mastoid  joramen,  and  at  the  jun<tion  of  tin 
tim])oral,  parietal,  and  (Heijjital  Ixmes,  where  the  lamlxloid  and  (Kcipitomastnid  sulures  iHconie 
continuous,  the  sigmoid  gnxjve  Ixnds  at  almost  a  right  angle  into  the  Iransrerse  i^roove,  so  thai 
the  posterior  inferior  angle  of  the  parietal  Ixme,  tlie  iiui\toid  ani^le,  also  aids  in  its  formation. 
The  transverse  gnx)ve  passes  across  the  inner  surfaci'  of  the  s(|uamous  puriion  of  ilu  (xcipilal 
lK)ne  as  a  markedly  shallower  gnx)ve  to  a  nudian  ( niiial  elevaiicn,  ilu'  crucial  niiiiumc,  whose 
(inter  forms  the  internal  occipital  proluhcronn  . 

The  (crebral  surface  of  the  (xdpiial  lK)ne  forms  by  far  lln  L'leater  iiorlii-'i  of  ihe  I'oor  of 
till  |>osterii(r  foss;!.  Its  basiinr  portion  forms  a  jiortion  of  the  su  called  ciii'ny  .1  steeii  lx)ny 
incline  p,i>sing  from  the  back  of  the  sella  turcica  to  ihc  lK)rder  of  the  foran-n,  ..lagnuni;  the 
anterior  |M)rlion  of  ihe  clivus  is  formed  by  that  part  of  the  Ijodv  of  the  sph-  ,ioul  which  is  situated 
anterior  to  the  original  spheno  o(  cipilai  synchondrosis.  Al  the  outer  side  of  tlie  eli\us  there 
In  the  shallow,  injcrior  petrosal  f^romr,  which  is  formed  In  tin  juiii  lion  of  tin  (xcipilal  and  .  11 
jHiral  lx)nes  in  the  |)etro  ixcipital  fissure. 

The  hileral  portions  of  the  cKcipital  !x<ne,  situated  to  i  iiher  .side  of  the  foramen  magnum, 
present  two  rounded  pmjections  u|x)n  their  cerebral  surfac  ■.  the  jugular  tubercles,  whose  Iwises 
■^X'-  trtivernd  b\  the  {)rrVh>us!y  nH'nlionn!  hyjnigins:^ii  or  anicrior  condyloid  cnnai,  and  Uiiiiid 
the  jugular  iinxess  (usually  in  the  Ixginning  of  the  sigmoid  gnM)ve)  is  situated  the  internal 
extremitv  of  the  condvloiil  canal. 


44 


|i    t 


ATLAS    AND   TEXT-BOOK    OF    HUMAN    ANATOMY. 

Fig.  46. — The  skull  seen  from  aix)ve  (i). 

X  =  foramen  parii'tali-. 

Fig.  47.— The  inner  surface  of  the  roof  of  the  skull  (calvarium)  (1). 


The  posterior  margin  of  the  round  jnramcn  maf^num,  situated  in  the  mifkllc  of  the  posterior 
fossa,  is  formefi  by  the  s.-juamous  jsortion  of  the  ociii)ital,  which  exhibits,  Ix'low  the  transverse 
groove,  two  concave  depressions,  the  inferior  occipital  joss(C,  which  are  separated  by  a  median 
riilge,  the  inUrnal  occipital  crest. 

THE  SUPERIOR  ASPECT  OF  THE  SKULL. 

The  super'"-)r  aspect  of  the  skull  (Fif;.  4O)  is  much  less  comitlicated.  It  shows  only  four 
Ixmes,  the  vertical  [KDrlion  of  the  frontal,  the  large  surla^.s  of  the  two  parietals,  and  the  apex 
of  the  squamous  |M)rtion  of  the  occipital.  The  visible  sutures  are  the  coronal  suture,  thi'  s;igittal 
.suture,  si'parating  the  parietal  Ijones  throughout  their  entire  length,  and  the  lamlyl-)id  suture, 
which  forms  an  obtuse  angle  with  the  sagittal  suture.  In  the  parietal  Ijone,  on  eilher  side  of 
the  sigittal  suture  and  at  alxnit  the  junction  of  the  third  and  fourth  (|uartei>,  there  is  an  orifice, 
the  parietal  jonimeii.  and  the  foreshorlenc<l  temporal  line  can  als(>  Ik'  seen. 

THE  INNER  ASPECT  OF  THE  CRANIAL  VAULT  OR  CALVARLA. 

The  inner  surface  of  the  cranial  vault  (Fig.  47 1  corn-jionds  to  the  outer  surface  ^viili  sliglu 
differenies.  It  presents  the  .s;ime  Ixines,  frontal,  parietal,  and  (k<  ipital,  and  the  siime  ^uture~. 
the  coronal,  s;igittal,  and  lamlxloid.  Upon  the  inner  surface  of  thi  sjigiita!  suture  wi  find  a 
shallow  groove,  the  saf^iltal  i^roove,  which  comnKnces  at  the  crest  of  the  frontal  Ijone  and  pa.s.si> 
Iwickward  over  the  jjarietal  to  the  iKcipital  lK)ne.  The  it  rebral  surfaces  of  all  the  lx)nes  of  the 
cranial  vault  show  \ascular  gr(K)ves,  the  sulci  arteriosi:  they  are  found  in  griatest  numlxrs 
upon  the  parietal  Ixtne  and.  next  in  fre(|uency,  u|)on  the  frontal  Ixme.  Small  inconstant  de|)res 
sions,  often  of  inion^id'.ra))le  depth  and  situated  i)articularly  along  the  sigittal  suture,  are  desig- 
nated as  the  jovcolic  f^raiiulares  or  pacchionian  depressions. 


THE  BONES  OF  THE  SKULL. 

After  this  consideration  of  the  skull  a--  a  whole  we  tu"-.  1"  llu  desiriplion  of  '.hi  iridi\idual 
Ixmes  of  the  skull.  These  nia\  be  divided  inln  two  groujis:  ( 1 !  the  Ixmes  of  tile  cranium  (.  raniiini 
nrehritli  1.  and  1 -"  llu  Ixmes  of  ilie  fau  [cranium  visc<rate).  Thi'  (  ninial  Ihiihs  art  the  ouipilal 
IxiMi  .  the  s[>lunoiit  Ixtne,  the  two  lim fioral  Ixmts,  the  two  paridiil  Ixtnes,  tin  jrontal  Ixiiie,  and 
tilt  illimoiil  Ixtm.  The  latial  Ixtnes  are  the  na^al  Ixmts,  tin  totlirymat  Ixmts,  thi  vomer,  the 
injerior  turbinolnl  hones  {concha  nasates  in'jcriores],  the  'iiaxillo,  tin  pitl.iU  boms,  the  zyjtioniittii 
Ixme-..  tilt  iiiiiwlihli ,  and  llu   liyoiil  Ixme. 

I'lr  liiituMif  llif  ^kiill  iiiuviIm.  (n  I  la^^ilii-.l  aniinlitiK  In  Ihr  mHli>Kl  ni  ilitir  (livilti|imfm  fsif  |iiim-  jt  I,  ami  (runt 
tlii^  Hi  a  nil  jM  lint  thiv  .in'  (ptitr  hfttr<n;r!n.«ti.,  ^trm  turf>;  -^umi-  of  thfiti.  .(h  li  a--  ttms*'  nf  tin-  lia'.r  nf  ittc  s^ull,  arr  »',  vcl- 
ii[«il  111  I  hi'  |iriiiiupli      '  atlilaKiniiii-  ■  i  iiiiiint.  «iitii   arr  iialiuii'.  .i(  llir  \i-<  i  i.il  -kiU  lull,  .iiitl  muui   an   -.n  >  .illril  n  ah  lug 


I 

s 


M 


lu 


i¥y 


I 


THE   BOiJES   OF   THE   SKULL. 


45 


or  dormul  iM.n.s  which  serve  to  close  in  the  cranium,  the  upper  ,x.rtion  of  which  is  unrepresented  m  the  .arflapnuus 
primordial  skeleton.  Only  a  part  ..f  the  cranial  l»nes  are  preformed  in  cartilage,  the  nu.jonty  be.nK  formed  by  d.re.t 
ossification  of  connective  tissue.  Those-  which  are  preformed  in  cartilaRe  are  al.so  known  as  pnmord.al  In.nes,  and  they 
are  the  occipital,  with  the  exception  of  the  upper  part  .,f  the  s<|uamous  ,K>rtion,  the  phenoid,  w,th  the  exception  of  .he 
internal  plate  of  the  pterygoid  process,  the  entire  ethmoid  and  the  inferior  turbinal,  and  the  petrous  and    mastoid  ,K,r- 

tions  of  the  temporal.  .  ■    •.   ,   .1  ■  ,   1 

The  cranial  In.nes  formed  in  membrane  are  the  upper  part  of  the  squamous  porti.m  of  the  .,,,,, ,.tal,  the  ,K,net..ls, 

the  frontal,  the  s,|uamous  and  tvmpanic  porti.ms  of  the  temporals,  the  vomer,  the  na.sais,  and  the  lachrymals. 

The  onlv  portions  of  the  visceral  cephalic  skelet.m  which  are  preformed  in  cartilage  and  are  to  Ix-  regarded  as 

primordial  bones  are  the  hvoid  and  the  small  auditory  ossicles  situated  >vithin  tlf  t.n,poial  lK,ne.     The  follo«w.g  bones 

of  the  face  are  f.,rmcd  in  membrane;   the  maxilhe,  the  palate  bones,  the  internal  plates  of  the  pterygoid  processes  of  the 

sphenoid  Inine,  the  zygomatic   bones,  and  the  mandible. 


) 


THE  Cranial  Bones. 

THE  OCCIPITAL  BONE. 

The  occipital  lionc  (Figs.  48  to  51)  is  comi)osc(l  of  tiirec  jKirtions  which  arc  not  shari)ly 
separated,  and  of  these  portions  one  is  i)aired  and  two  are  single.  They  are  termed  the  basilar 
portion,  the  laUral  portions,  and  the  squamous  portion,  and  are  groupctl  alK)ut  the  joraimn  ;«(/,(;- 
num  in  such  a  way  that  the  basilar  jwrtion  is  in  front,  the  lateral  jwrtions  are  to  cither  side, 
and  the  stiuamous  portion  is  Ix'hind  the  foramen. 

The  basilar  portion  of  the  adult  skull  and  the  body  of  the  sphenoid  Ijonc  arc  united  by 
osseous  tissue  (Fig.  51),  but  up  to  the  time  of  puberty  they  are  articulated  by  the  splinw-oaipital 
synchondrosis  or  fissure  (see  page  47)-  The  lower  .surface  of  the  basilar  portion,  which  lomis  a 
[)art  of  the  external  surface  of  the  base  of  the  cranium,  lies  almost  horizontally,  but  the  cerebral 
surface  i)asscs  oblitiuely  from  alx)ve  downward  and  from  iK'fore  backward  and  forms  the  clivus 
(Hlumcnbachii).  The  inferior  surface  (Fig.  50)  presents  a  median  projection,  the  pliaryufical 
lubinl,',  for  the  attachment  of  the  pharyngeal  ajmneurosis,  and  to  cither  side  are  roughened 
surfaces  for  the  in.sertions  of  the  rectus  capitis  anticus  minor  and  major  muscles. 

The  surface  of  the  clivus  (Figs.  4,^,  44-  and  51)  is  slighth  concave  and  its  lateral  margins 
exhibit  a  gnnive,  fre(|uently  c|uite  shallow,  the  injerior  petrosal  f-romr,  which  forms  with  a  similar 
gr.Kive  of  the  temi)onil  iK.'ne  (see  page  55),  over  the  pctro-occipital  fissure,  a  tl,..nncl  for  the 
inferior  ))etros;d  sinus  of  the  dura  mater. 

The  lateral  portions,  also  termed  the  condyloid  portions,  extend  posteriorly,  and  gradually 
become  broader  and  thinner  as  they  i)ass  into  the  .sciuamous  portion  of  the  Ixmc.  The  ir  most 
important  structures  are  the  condyles  (Figs.  41,  4-',  4^,  and  50),  which  are  situated  upon  their 
inferior  surface  and  articulate  willi  the  first  cervical  vertebra.  The  articular  surfatrs  of  the 
tondyles  are  reniform  in  shape  and  are  markedly  conve\,  particularlv  from  Inforc  backward; 
they  Cxtend  from  the  anterior  margin  to  alxiut  ojiposite  the  middle  of  the  foramen  magmmi, 
hut  only  their  posterior  halves  iHirdir  directly  uixm  this  opening.     Uehind  the  tondyles  ihcre 

i^  a  depression,  the  c(.'«t/v/(>a/ /.•••sij  J  rg.  4r'-,  w. in  HT     ii.-.i c.uuii  c.i  ..i.e.  fin 

a  so  tailed  emissary  forainen,  and  the  base  of  the  condxle  is  traversed  from  side  to  side  by  the 
hypofilosuil  canal  (Figs.  4c;  and  50),  through  which  the  twelfth  cranial  nerve,  the  hyiH)glo.ssal, 
leaves  tlic  skull. 


46 


ATLAS    AND    TEXT-BOOK    OF    HUMAN    ANATOMY. 


Fu;.  48. — The  occipital  bone  seen  from  behind  (i). 
Fig.  49. — The  oc(i|)itaI  bone  seen  f-om  in  front  (i). 
Fic;.  50. — The  occipital  bone  seen  from  below  (J). 
Fig.  51. — The  occipital  and  sphenoid  bones  seen  from  above  (i) 
fused  with  the  middle  one. 


The  right  anterior  clinoid  process  is 


Upon  the  outer  margins  of  the  lateral  portions  of  the  Ijonc,  projecting  toward  the  temporal 
bone,  there  is  a  prominence,  the  jugular  process  (P'igs.  48,  49,  50,  and  51),  in  front  of  which 
is  situated  a  notch,  the  jugiiler  notch,  which  is  sulxlividcd  by  a  small  iitlrajugiilar  process  (Figs. 
50  and  51).  into  a  small  anterior  and  a  larger  ]x)sterior  compartment.  By  apposition  of  the 
notches  to  corresiwnding  notches  of  the  temporal  lx)nc  there  is  formed  the  jugular  joramen 
^F'K'^-  43  snd  44),  which  is  divided  into  two  comj)artments  by  a  ligament  extending  between 
the  corresjwnding  intrajugular  processes  (a^e  page  55). 

The  inner  or  cerebral  surface  of  the  lateral  jwrtion  of  the  occinital  exhibits  a  blunt  pro- 
tuberance, the  jugular  tubercle  (Fig.  51),  above  and  to  the  outer  side  of  the  internal  orifice  of 
the  h\ix)glossal  canal,  which  consequently  passes  through  the  lateral  portion  of  the  bone,  below 
the  jugular  tubercle  and  alx)ve  the  condyle.  Heside  the  jugular  process  and  beginning  in  the 
jugular  notch  is  seen  the  commencement  of  the  sigro'd  grooir  (see  ]jage  43),  which  cur\es  over 
the  cerebral  surface  of  the  jugular  process. 

The  largest  jwrtion  of  the  occipital  tx)ne  is  formed  by  the  squamous  portion,  which  is  flat 
and  moderately  curved,  and  in  which  an  internal  and  an  external  surface  be  recognized. 

It  is  lx)unded  by  the  (xrcipitomastoid  suture,  forming  the  mastoid  I-  r,  ar,.i  )V  the  lambdoid 
suture,  forming  the  lambdoid  border,  and  its  apex  is  situated  at  the  posterioi  vtrcmitv  of  the 
sagittal  suture. 

The  most  striking  formation  up<m  the  rather  markedly  concave  internal  or  cerebral  surface 
(Fig.  4())  is  the  crucial  rmincmr,  the  ridges  of  which  form  four  shallow  fossa-,  two  superior 
occipital  josstr  and  two  iiijerior  occipital  jossa:  Tlie  middle  of  the  iross  is  formed  by  the  internal 
occipital  protuberance,  while  the  inferior  median  limb,  the  internal  occipital  crest,  [)asscs  to  the 
posterior  margin  of  the  foramen  magnum.  The  remaining  three  limbs  are  gnxnes  produced 
by  the  venous  sinuses  of  the  dura  mater;  the  two  lateral  ones  are  called  the  transverse  grooirs 
and  the  sui>eric)r  one  is  the  posterior  extremity  of  the  sagittal  gnnrce  (see  page  441. 

The  external  surface  of  the  scjuamous  portion  (Fig.  48)  is  markedly  convex  in  lx)lh  the 
sagittal  and  transverse  directions,  and  is  divided  into  two  surfaces,  an  inferior  nuchal  surf:'ce 
[planum  ««(7/(j/(),  roughened  for  the  insertion  of  numerous  nniscles,  and  a  superior  smtxither 
triangular  occipital  surface  (planum  occipitale).  These  two  surfaces  are  .separate<l  by  the 
su|)erior  nuchal  line,  a  roughened  ridge  for  muscular  attachment,  which  passes  in  a  curvwi 
direction  from  the  external  occipital  protuberance  to  the  occii)ito-mastoid  suture,  and  a  short 
(lislaiue  above  ilie  linea  su|)eri()r  we  observe  the  somewhat  more  sharply  curved  litwa  suprema. 

The  entire  jjlanum  nuchale,  from  the  external  (Kcipital  jirotuberance  to  the  foramen  mag- 
num, is  traversed  by  the  external  occipital  crest.  From  alxiut  the  middle  of  this  crest,  and  parallel 
to  the  linea  su|)rema,  there  pa.s.ses  outward  the  injerior  nuchal  line,  ujwn  which  there  arc  fre- 


i 

L 


Planum  ccdi>itiile 

I  xlenuil  cccipittil  itivtiihrranct 
/  "'."'^^1^^^  l.itiiii  niichdc  ■<iii>miui 

I'laniiin  niicliaU' 


Superior  niichnl  line 


Squama  occipitalis  Jf 


'nferior  niiclnil  line 


Comlvloid  ecinnl 


I'hiinini  iiiichdle 

Lateral  portion 

('('ndyloid  tossa 


Hvim^lflssal  eaniil 

f'onimeii  ni<i<>nnni 


liisiiiliir  /imeexs 
Oiiipitiil  eondvli' 


lixlerntil  iHcipiliil  cresl 
S(i!iitt(tl  i;roove 


hlr,   VS. 


'/'n/wsiv/v  <'V(>('iv 


Inlirnul  occipitiil 
fimtn/ieniine 


Inlertiiit  cccipilnl  cresl 


JiiiTiihir  /I'lUi 


IjinilultUil  border 


Sii/ierior  tiecipilal 
fossa 


liilerior  oeeipiliil 

lOs'.ll 

Mi/sfi'id  lionler 


Condyloid  riini/l 
/ii!;nlar  Inherrle 

Hvpoi^lossid  canal 


( tccipilnl  condyli 


P  M 


Basilar  portion 


I'iir.     10. 


r-  »i 


'.ifm^'^'^y^i. 


Basilar  portion 


Hv/iof^lossa!  ainal 
/iitm/iii^ii/iir  />ro(iss  -^ 


I'ltarvngi'iil  tiihervlr 

I  ortiinni  nuif^tniii! 

ihii/'iral  ioiuIyIi' 

Jdi^nliir  notill 

Itiiriilar  process 
^  .   i0   Lateral  portion 


Fif;.  50. 


Si/iKiiih'iis  /),'rnoii 
I  lontiit  honlcr 


liififii'r  iiiiclliil  liilf 
I'hiiuim  iiiitiiii/r 


I'lllictlll 

iiiwlr 


.\itleiirr  Elhnio-  ri^^iti; 

clinorit    Optic   itirl    t)livnry    Oftric 
/^/I'lV -^  'groove  s/)i'!i  proft^^  lommftt 


Siiiitiiihnis  lunJer 


I'l'^ltTior  cUnoid  prongs 

lillriiiti!;iil(ir  /iroas  s 
liii;iilur  iH'Icli 


I- in.  il. 


Pttiiiidl 
tiiivje 


Si;j;nhnd  y/'iKH'i 


/  tVtiiiirii  rolinuliim 

I  'Vltllhll    (M'l//r 

/  iviiiiicii  f./iiiicisiiin 

I  ill  nil  I II 
Splhiu'-oicipiliil  syiirlioiiiln'-'i-^ 

lui^iiliir  liil'i'i'iii 

lii!;ii!iir  pri'irss 

.WisiDiil  ItonSiT 


I  aiiihilohl  I'urJir 


:  H: 


:      i 


I 


//•|7//M<7 -(     I'liU'VI 


^n,  ^j 


r 


■   .1 


If! 


f 


m 


'^*«ahi 


THE   BONES   OF   THE   SKUI.I.. 


47 


f 


qucntly  two  particularly  wdl-markcl  n^ught-ntd  ri.iges,  the  crrsi  jor  Ihr  rectus  aipith  poslnus 
mahr  muscle  and  that  for  the  rcclus  minor. 

The  rdalions  of  the  occipital  hone  t(;  the  nuiKhljoring  b<incs  of  the  >kiill  liave  been  pre- 
viously dcscribcfl  on  pages  3S  and  to. 

Onlv  the  basilar  ,,nrtion,  the  lat.ral  ,...,. i.,.,s,  aiM  .h.  1,  .,r  ,.,-..  of  Ih.-  squamous  ,K,r.ion  ar.  ,,n-f..nn..<l  in 
cartilage,  the  u|,,„.r  part  of  the  .n.uamous  ,.om„.  ah.  planun-,  , . ,  i,,i,..l,  )  l«nR  form,.,  in  n.emhrane.  At  the  ..^.n- 
ninsrof  the  fourth  fetal  month,  four  (or  five)  ooin.s  c,f  us.ifuaiion  ,.|.,H-ar.  one  in  the  ba»lar  port.on.  one  u,  ea>h  lateral 
norL.an.l  one  ...r  tw„)  in  the  lower  par.  of  .l,e  s,,uam..u.  portion.  The  upper  part  of  the  s.,uaM,ous  port.nn  ,. 
'eparately  formed,  and  i.s  partly  isola.e.l  from  the  nmain.ler  of  the  l.one  un.il  after  birth  by  a  suture,  the  .H/«r„  „,n,.!os.,. 
-.Imetimes  the  part  of  the  s,,uamous  p.,rtion  vvhi.  h  is  r„.t  pref-rnu-.l  in  -arula.e  renjains  tndepen.lent  Irum  the  per- 
-,..en. .  of  the  sutura  memlosa,  and  forms  the  triangular  ..  i„„rf,arir,..l,-  (  .  i,,..).  Inr  a  lon^  tmte  after  b.rth  (ur,.,l 
the  end  of  the  f..urth  year)  the  h.ter.al  portions  are  se,.arated  fmm  the  body  and  fnm.  the  lower  part  of  the  s.,uamou,s 
I)onion  by  thi-  .interior  and  posterior  intrronipit.:!  synchonJros,^. 

THE  SPHENOID  BONE. 

In  its  form  the  sphenoid  bone  (Figs.  51  to  54)  some\vhat  resembles  ..  v.  .iged  in>ect.     It 
consists  of  the  following  parts:    (i)  The  body;    (2.  the  two  gm//<T  ^■iui^s  (al.-o  called  the  ln„- 
Ihi.' iwo  hsscru'iniis  (also  tailed  the  orft/A;/ -a'/»,?.v);   (4)  the  pUryt^oid  processes. 


poraliL-ings)\  (,V) 

tr~x. 

tempo 
f  I  surface 


orbital  surface 


infratemporal  pi^"^ 
'  surface        b'V*'      ^ 


\  .     7  \  \   ^f  orbital  crest. 


iphenomajcillaru 
surface 


Fio.   5:!. — The  sphenoid  bone  seen  from  in  front. 

In  the  adult  skull  the  .sphenoid  is  lirmly  united  to  the  oeeipital  hone,  the  two  together  formnv.; 
one  large  bone,  the  os  basihire  (I'ig.  51). 

The  body  of  the  sphenoid  (Fig.  52)  forms  the  renter  of  the  hone,  from  whieh  all  ihe  other 
portions  radiate.  Posteriorly  it  articulates  with  the  oteipiial  bone  {spheno-occipita!  synchon- 
drosis, see  page  4.s\  and  anteri-r!y  with  the  .■thmoi,!  hn-ie.  Its  uimer  '-nrfare  is  formed  by 
the  sella  turcica  (Fig.  54);  its  lower  surface  forms  a  jiortion  of  the  external  surface  t)f  the  base 
of  the  skull  (Fig.  42)  and  articulates  with  the  ala  vomeris  and  the  s].henoidal  process  of  the 
palate  bone.     It  contains  a  cavity  communicating  with  the  nasal  fossa-,  the  sphenoidal  sinus, 


48 


ATLAS   AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 

Fig.  53. — The  sphenoid  bone  seen  from  in  front  (j). 
Fig.  54. — The  sphenoid  bene  seen  from  behind  (|). 


which  is  completely  divided  into  two  [wrtions  by  a  siiRittal  septum  which  is  rarely  situated 
exactly  in  the  median  line.  The  two  sinuses  communicate  with  the  posterior  superior  portion 
of  the  nasal  fossoi  by  means  of  irregular  openings  in  the  anterior  surfa'e  of  the  Ixxly  of  the  s])hem  'd 
Iwne  (Fig.  53).  The  greater  portion  of  the  almost  rectangular  anterior  surface  of  the  lx)(ly 
(Fi^s.  s->  and  53)  is  formed  by  two  thin,  appro.ximately  triangular  bony  ])latelets,  the  sphenoidal 
lurbitiatcd  bams  (concltm  sphcnoidalcs),  which,  although  usually  unite<l  with  the  sphenoid,  are 
to  be  R'ganle<l  as  ijortions  of  the  ethmoiel;  they  are  frequently  continuous  with  the  ethmoid 
and  may  Ix;  represented  by  a  number  of  small  indejK'ndent  lx)nes  {ossa  Birlini).  'They 
form  the  inferior  margins  of  the  a|K'rtures  of  the  sphenoidal  sinuses,  and  in  the  neighborhood 
of  the  ai)crtures  some  small  fossx  which  close  in  the  jxistcrior  ethmoidal  cells  are  freciuently 
\isible. 

The  anterior  extremity  of  the  septum  of  the  sinuses  appears  upon  the  anterior  surface  of 
the  Ixxly  of  the  sphenoid  in  the  shape  of  a  low  ridge,  the  sphenoidal  crest  (Fig.  53)-  It  is  con- 
tinuefj  U])oii  the  lower  surface  of  the  body  of  the  sphenoid,  where  it  Ixromes  more  pronounced 
and  forms  the  sphenoidal  rostrum,  to  which  is  attached  the  ala  vomeris. 

The  upper  surface  of  the  !xK!y  (Figs.  43,  44,  and  51)  is  the  most  stningly  marked  surface 
of  the  lx)ne.  Its  most  striking  structure  is  the  so-calk-d  sella  turcica  (see  al.so  page  41),  which 
is  that  ]K)rtion  of  the  upper  surface  of  the  Ixxly  which  Ixlongs  to  the  middle  cranial  fossa,  smaller 
portions  of  the  IxkIv  helping  in  the  formation  of  the  fl(H)rs  of  tlie  anterior  and  of  the  posterior 
fos-sa-.  The  jKjrtion  in  tlie  anterior  fossii  is  a  plane  surface  in  fnmt  of  the  sella  turcica,  con- 
nc'  ting  the  two  les.ser  wings,  and  is  calletl  the  ;h,i;«w  sphenoidair;  towarrl  the  adjacent  lamina 
cril)rus;i  of  the  ethmoid  Ixine  it  presents  a  process,  the  ethmoidal  spine  (Fig.  t;il,  the  shajie  01 
which  varies  greatly  in  dilTerint  individuaLs. 

Behind  the  jugum  sphenoidale  at  tlie  anterior  margin  of  the  sella  tunica  there  is  a  shallow 
groove,  the  optu  i^roow  (sulcus  chiasmatis),  so  (alle<l  Ixrause  it  lontains  tlu  di-cus.siition  or 
(hiasm.i  of  the  "jUic  nerves  (Fig.  51).  It  is  continued  on  either  side  into  the  optic  joranuv, 
wiiic  h  Kails  itiio  tlu-  orbiud  caxity. 

Hehind  the  uptii  gnH)ve  the  Ixxly  of  the  sphenoid  presents  a  flat  elevation,  tlu  itiivary  emi 
neiue  (tulhrniluin  sella  1,  \]\v  margin,  of  wiiii  h  somdinus  give  origin  to  tin  inconstant  nuddU 
fliiiotd  pr(Hes;es,  and  U'twirn  the  iminen<e  and  the  higli  back  of  llu-  siiddlt,  the  dorsum  siila. 
lli(  n  i>  siluatecl  a  ratiier  deep,  slightly  cllipti.  al  de|>»Ts.sioii,  the  hypophyseal  jossa,  which  Uxlges 
the  pituitary  Ixxly  or  hypophysis.  On  cai  li  Mdi  of  this  foNs;i  dure  is  u|iiin  tin  nxit  of  Mie  grcilc  r 
wing  of  the  sphenoid  a  >-ha!l.)vv  but  rather  broad  gnxvvi,  situated  at  llu  ju;i(lion  of  llu  upper 
•md  lateral  surf,u(s  of  the  Ixxly  of  the  sphenoid  Ixme  and  limited  externally  low.ird  the  greater 
wing  of  the  -phenoid  by  ;i  fi.U'  Ixmy  piiitdtt,  tlie  lin)iula  (Fig.  ^\).  Tills  gnx-ve  i--  calleil  ihi 
larolid  .i;n ntv   ( '  ig.  i;4i,  since  it  Uxlges  tlu  inlrrnal  lanilid  arliry. 

The  dorsum  sell.e  Ixarv  u|M>n  1  ithir  sidi  slightly  [xjinted  shar]>  (orners,  the  posterior  liinoid 
proiessi  -       hi  hind  llu  dorsum  s,  ll.i  ,1  |.()rtioii  of  tlu  1  livii     ^o  Ix  long-  to  tin  Ixxly  of  ihe  sphenoid 


frontal  border 


Orhitiil  ^11  r Hue 
ronimen  rotiimiiim  ol  prahr  wing: 

Lesser  wing^ 

Arrrriin    of  <rhn„'„l„l  siniK  Sunrrior  orln/,,1 

Sphfumliil  liiihilliltcl  ''■""' '■ 

honf 
Spliciioii/iil  irrst 


Millar  horiirr  'Wi^ 

liifriitimporiil  ^nrfun 

S/ilif/ioniii  \illaiy  snr/iiir 


■7  Iniiponil  siirfiur 
(>/' i^rriilir  wiiii;' 

lii/riilrm/'onil  ruli;r 


'*^-'  J  "'I'll 

mini  /itnygoiil  pliilr  J 


//if.  57. 


S/IIIIOIIS  /l/(l('C>.'> 

Purviiniialdtiiir  groove 
/  \/eni(il  plerygoiil  plute 

I'tiivgoi.l  //■•■-lire 
H  imiilar  proee^^^- 


flllhlltl    'tllt'h 

.'I  ^irnii'i 


l)or--iiiii         /'.isf.  elinoiil  proe. 
"'■''''"  .\iit.  elinoiil  proe 

I  csvcr  Willi; 


■i 

■  If 


I'.ineto! 
iiiiale 


S"/;A//?  iirlerio^iK 


$\  nam  011% 
I'onler 


(  iiroliil gi'ioie 
I'tfrvgoiil  eiiiiiil 


hihrifii  pleryi:oiil 
pintr 


Spnioii\  proee^^ 

(iiOf  I   lor  I  11^1,1,  III, I'l  lul'e 
seiiplioiil  'civv( 


^/  'inio-oi,  //iihil     y 
-v'lthoiiilri'^i^i     > 


/  \leiiHil  pferxyoiil  plile 
lloninlii'  /"iii/o 


IS 


i  '■ 


til'    il. 


I  \i 


THE   BO.\'ES   OF   THE   SKULL 


49 


bone  (see  also  page  43).  -hich  thus  aids  in  forming  a  part  of  the  flo<,r  of  the  ,K,sterior  cranial 

'""l^!?",SLior   surface  of   the   body   of   the    sphenoid    .>one    (Fig-    54)    is    adhen.nt    ,0 
.he   I^pil^    U.ne.       In   young    indivi.iuals.    if   a    synchon<lrosis   st.ll    ex.sts,    the    surtace    . 

^""IC'I,;:::;':  plrfon  of  the  lower  surface  of  the  .x.ly  of  the  sphenoid,  l^e  the  anterior  on. 

1  tu  Kriaicr  1  shhcnoidcl  rostrum.     On  this  surtace  there 

forms  a  »--d=^^,;'f;,;;;'^;.^^„  "  Lais,  the  inner  of  which  i.  the  ,.sip>u.yn,eal  aural 

:ng  ;;r:.x  hr:rr^:::x:e  whic.;  is  t... ..,..,/  pro..  ..f  ,he  ptery...  pn.ess 

,Ki.r    -11   i<  the  *//<Jrv«j?»'a/<<Jfw/ (Fig.  5.1)  (seealso  page  51).  .         -^ 

'm  1  ,  n  1    urfac!  of  ,he  Ix.ly  of  the  sphenoi.l  l.ne  give  origin  to  the  two  g:.ater  w.  gs 

of  thl'l-lllid,  while  the  pterygoid  processes  arise  fron.  the  lower  surface  o.  the  hody  of  the 

'"^Thc  lesser  or  orbital  wings  are  narrow,  almost  horizontal    l.ny  plates  -^}--^  ^^^^ 
.     .       iZ-  suhenoid  t..ne  bv  two  rcK.ls  which  surround  the  opl„    loram.M  ,lMg.  5.).     1  hur 

xnd  .4,      It   leads  into  tl,e  orbi-   and  its  gr.at.r  p-nion   is  .los-d  In  a  mcmb ran   .  .    M 
"1^:  to  the  nerve.  ..f  the  ocular  muscle,  ahc  .Hulomo.or.  th.  al.iucensanclh..  trochlea-  ,. 
UK  r.rst  or  oph.halmi.  division  of  the  trigeminus,  an.l  to  the  ..p^r.or  ophtha  m..     nn. 
The  grea  er  or  temporal  wings  of  the  .phcnoid  a,i..  .n.m  th.-  lateral  --f- ; 
,..,v  of  tl!  .plunoid  bv  broad  r..,.  it,  .hi.h  are  situated  ,1....  op.aung.  th.  ,.-n.K.J  n  ^  ^-^ 
H  mr.,m<«   ..„/,    and  tlu-  lor.mrn  spinosum  (Fig.  ;-  >.     The  tora.nen  n.lu.Klum  lead.  -1  l.qu.lv 

:,.'         '   Ir     .h  du-  l...:^'  into  ,h:  sphenotnaMllary  fo.a  „o.so   pUr.,o,„., .and  tran>- 

;  I    ,    nlvilh^v  nerv..  Mhe  second  division  of  the  trigendn,..     Th.   .uram.n  ,na   ■  trav... 
C  1      .   in  a  ver.i.al  .lir.-t..,,  an.l  tnak..  its  ..i,  upon  the  ext.rnal  sur.ace  .,    th.^  Ik^c  o.    h. 

ull    l.e  page  V,.  an.l  Fig>.  4.  and  ,..;    h  .ran.nits  tlu-  man.libular  n.rv..  ,.he  th.rd  .l.vM, 
:!;7h.!^ri^.n'nus,.     The  f-ramen  spinosum  pursu.-s  ,h..  .un..  .lirot.on  and  g.v..  passage  ,0 

the  miildle  mining,  al  artery*  liiimilv 

The  gre,.,.r  wu.g,  lik.  th.-  less.,  on.,  i^  pra.  ti.  allv  hori.o,  tal.      it  , .-^.  ,  u.v  .l.-..n,  tl 

.e,nr..  1  surfaces,  ti;  .en/.,,/,  th-  orl.U,!,  and  the  ,n„por„L  and  tlu  -v  n.-,  aUo  U   n.  ...n.,..l 
TPiJlZ^Irr  ,Fig.  .n.  th..  verv  rough  margin  .lin.t.d  to.anl  tl,-  front  d  ,  a  -.,o,na,., 

,  ,,      u    n.l,Mr,lH,l     >Ul...ual.  ,ml.'...rrr.tly,.„..,i,.n»!  l-">'i"    '"-l^  ■•'    ""    ■I'''" 

mill      ,1, ,.1. a  Ulwr.li  llif  for.imrn  rnliiMilmii  .ui'l  ,A. Ill-   111    ."I'O"' '■■""""  ' 

n.,i,l  1.1  ihr.M    r.«.tv  .1  mi.l.lli- lir 1  n-.l,  Mli...t..l  lHl»...iin.  i„i,i,,i,  llu  f..riiiiT  n\ac 

...,«..„   .h..  f.irani,-  m.un.tun,  ;in.l  ,1,..  ,,,h.  n..*.l..l  O^Mir. ,  ami  „  v.  r,  -.a,ri,«  ,Ki.l.ru.,  ...u,  Ik.mi.i.Uh         ,, 
an.!  .|.,n.m.m.     TW  laU.r,  h.,«.i.i.  >  an  «ar,.lv  I,.   r.R.ir.lr.l  a,  a  r.K,!. 
1 


m 


so 


ATI.AS    AND   TEXT-BOOK    OF   HUMAN    AXATOMV. 


I 


border,  in  contart  with  the  zygomatic  bone,  and  a  squamosal  border*  direrted  toward  the  tem- 
poral lK)ne.  The  most  external  jjortion  of  the  greater  wing,  which  is  in  contact  with  the  parietal 
lx)ne  in  the  spheno]'arietal  suture,  is  known  as  the  parietal  angle,  and  its  most  jjosterior,  jjointed 
portion,  which  is  directed  toward  the  pet-  :'s  portion  of  the  temjwral  Ijone,  is  called  the  spine 
(Fi«s.  53  and  54).  The  cerebral  surface  is  distinctly  concave  and  exhibits  the  interna]  orifices 
of  the  joramen  rotundum,  m-ale,  and  spino.-,nm  (Fig.  51),  the  last  receiving  its  name  on  account 
of  its  location  in  the  spine. t  It  also  cKcasionally  shows  digitate  impressions  and  cerebral  juga 
(see  i)agcs  41  and  61),  and  a  suteiis  arteriosus  which  is  continued  from  the  temjKiral  bone. 

The  ahnost  plane,  slightly  concave,  (luadrangular  orbital  surjace  (I'igs.  38  and  53)  is  thi 
smallest  of  the  three  surfaces.  It  forms  a  jjortion  of  the  outer  wall  of  the  orbit,  and  in  this  situ 
ation  its  zygomatic  border  articulates  with  the  zygomatic  lK)ne  by  nu:in>  of  the  sphrnozygomatie 
suture.  The  sijhenomaxillary  or  inferior  orbital  fissure  sei)arates  the  greater  wing  from  the 
maxilla,  and  at  the  margin  of  this  fissure,  the  orbital  surface  jkjsscssc's  a  sharp  edge,  the  orbital 
crest,  which  sejiarates  it  from  the  sphenomaxillary  surjace  (Fig.  53),  a  lower  iK)rtic>n  of  the  tem- 
]K)ral  surface.  In  the  vicinity  of  the  superior  orbital  fissure  the  orbital  surface  exhibits  a  lx>ny 
spine  of  variable  development  which  is  called  the  spina  recti  lateralis  and  is  the  j-oint  of  origin 
for  the  muscle  of  the  same  name. 

The  temporal  .surjace  (Figs.  3c),  40,  and  SS'I  '^  ^y  ^'•^'^  l'^'^'  liirj.'"--^'  o^  t'lc  three  surfaces  ..f 
the  greater  wing  of  the  sjihenoid  and  is  distinctly  angulated  at  the  level  of  liic  injratemporat 
crest  (see  page  3c)).  Tlie  almost  vertical  portion  of  the  tem]K)ral  surface,  situcted  above  this 
crest,  forms  a  iK)rtion  of  the  planum  temporale  (see  ])age  38),  while  the  portion  >ituated  IkIow 
the  crest  is  divided  into  the  more  horizontal  injratemporal  surjace  and  the  triangular  splunv 
maxillarv  surjace  b\  a  ratlu  r  low  ridge  wliich  is  called  the  splienomaxillary  ridg<.  The  spheno 
maxillarv  surface  1  Fig.  53)  lcx)ks  rather  anteriorly  and  overlaps  the  rcK)t  of  the  |ilcrygoid  prcness, 
while  the  infratemporal  surface  is  directed  more  to  the  side,  and  jiresents  the  external  orifices 
of  the  foramen  ovale  and  the  foramen  spinosum.  Jt  forms  tile  jiostcrior  wall  of  thi  pleryiio^ 
palatine  (sphenomaxillary)  jossa  (see  jjage  781,  and  contains  the  anterior  or  external  orifice  nl 
the  foramen  rotundum.     It  is  sharjly  separated  from  the  orbital  surface  by  th.    orbital  crest 

I  Fig.  53). 

While  the  greater  and  U-ser  wings  of  the  sphenoid  are  practically  horizontal,  the  third 
pair  of  ])nKes>es,  tlu  pterygoid  processes  iFigs.  53  and  ;4i,  pass  abvio-t  Miticallv  down.vani 
and  are  aiijiosed  1  Fius.  41  and  4.>i  to  the  posu  rior  surface  of  thc>  maxill.i  (>ee  page  071  and  to 
the  iiard  |)alate  (-ee  page  79),  forming  the  lateral  l)oiindarie>-  eif  tin-  posterior  iiares,  F.ac  h 
pteryi^'oid  pnHcs>  arises  from  the  lower  surface  of  tin  \»«\\  of  the  sphenoid  by  two  rcMJts,  Ix'twceii 
whiili  is  the  plirygoiil  '\'idian\  lanat  (Fig.  ^},),  uhjeh  runs  almost  liori/.ontalh ,  il-  anterieir 
extremitv  being  in  the  ptervgeipal.itiiie  fossii,  and  its  |iosterior  one  in  llie  loramc  n  laecrum. 
Heleiw  the  |)ter\ge)id  canal  the  pteivgoid  process  di\ielc-s  into  two  lamella,  tlu  intirmit  and  the 
t\l,riiiil  pterygoid  plate,     '{"he  internal  jilate  i>  narrower  and  .ilniost   vertically  placcel,  while 

*  s<i  n.inieel  "he  rr  ii  hcmli  r^.  ei|iiiei  Kh  vi|u.iiiiijus  Ixireimi  uf  ihi  1.  iii|K(ral  l«'eie  j  in  the  reaion  'if  ihi  -I'lii  ii")»  Irn^il 
ti,.urr  ' '•et    paui-    C'f   il    i>  <.e!ie»i   Iht    ftiltttS'll  ftt'rtirr, 

i  C)(  eaMi>ii.illv  ill!  fiirunuii  spinosum  i^  imly  ii.iniall>  Imiilnl  In  Ihe-  ^|i!ieniiiil  U.iii-,  i  f.,  il  i>  »ini|il>.  k  mn.  Ii  in 
!h.    spine. 


THE   RONKS   OF   THE   SKUI.I,. 


51 


the  external  plate  is  broader  and  directed  more  externally.  Between  the  two  is  situated  the 
pterygoid  jossa,  which  is  nanow  above,  wide  below,  and  open  iKisteriorly,  and  whose  anterior 
inferior  lx)undary  is  formwl  by  the  tuberosity  o;  ,  ;ramidal  protess  of  the  palate  Ix.ne,  which 
closes  the  space,  the  ptcrvgnkl  notch,  between  the  two  plates. 

At  the  base  of  the  internal  plate  there  1.  a  small  elliptical  fos.sa,  the  scupboul  jossa  (Pig. 
54),  to  the  outer  side  of  which,  toward  the  spine,  there  is  a  shallow  -hk.m',  in  whi(  h  is  situ.ited 
the'cartilaginous  iK)rtion  ..f  the  Eustachian  tube  which  connects  the  mid.ile  ear  with  the  naso 
pharynx.  M  its  lower  end  the  internal  plate  terminates  in  the  slender  h(X)k  like  hamular  i)ro(ess 
(humulus  ptcrygoidms)  (Fif;s.  5;,  anfl  54),  the  gnx.ve  at  the  ba.se  of  this  Ixin^-  called  tiie  iMmulor 
i^rooz'c  and  forming  a  puUev  for  the  tendon  of  the  tensor  vi  li  jjalatini. 

Beside  the  scai)hoid  fos.sii  is  situated  a  small,  flat,  rather  trian^^ular  pnKes.-,  calk-<l  the  vaginal 
process  (Imj,'.  54),  which  is  directed  toward  the  si)henoidal  rostnjm;  together  with  the  sphem.idal 
process  of  "he  palate  bones  it  aids  in  the  formation  of  liie  pharyngeal  canal  (sir  page  49I. 

Ui.on  the  anterior  surface  oi  the  pterygoid  process,  running  downwanl  from  the  anterior 
extremity  of  the  pter%goid  canal,  llure  is  a  shallow  grcK)ve,  the  pterygo  palatine  grome  (Fig. 
M),  which,  with  similarly  nami-d  grooves  upon  the  i)alate  and  maxillary  Ix.nes,  forms  the  pterygo- 
palatine canal,  who-c   ■  xternal  orifices  are  the  pa'atine  foramina  of  the  har.i  palate  (see  i)ages 

40  and  7R). 

Since  the  sphenoid  Ix.ne  is  almost  ixa.lly  in  tin-  (enter  of  the  skull  and  has  relations  with 
i„,tli  the  cranial  and  the  ta(  ial  ".x.nes.  it  ailieulates  wiili  a  large  numUr  of  the  Ixmes  of  tin-  skull 
.see  page  ',7  ct  seq.).  These  are  the  <k  ( ipitals,  the  tempord,  the  (.arietal,  the  frontal,  the  ethmoid, 
the  maxilla,  th.  zygomatic,  the  palate,  and  the  vum,  r.  al>..  forms  a  portion  of  \\u-  .interior, 
middle,  and  ix-  -.'rior  cranial  fos.s;e.  of  the  orl)it,  oi  the  r,as;il  l.'v„c,  of  the  tem].orai  foss.',  of 
(he  intf,*t<miK)rul  fossie,  and  of  thi'  sphenomaxillary  foss;i-. 


!«■  ...li.l  Ih.it  lii'   iHlin    li.mi   i>  |ir.l..rmr(i  in  <  .irlil:iKr  "iili  ill'- 
s  :i:i.|  il\.    -I'll- '"'il  il  tiirhinalnl   U.iii-.,  'a  hii  li  ari'  ilrvi  lopcil 


A-  rcijanl^  ■=»-  'li  ■'  I'^nnirnt  .if  tin-  ^plir-iui.l,  ll  r.\, 

,.«ctiti<>n  .d  ihr  iiiumal  plali-;  '■!   lt»-  pliryK^i.l  [ircH , 

i„  „„.ml,r:in-       .K,rt....i.m  l«-«iM,  i.mar.i  ill.    .  „.!  of  ,l,r  „■,„„.!  f.t.,1  nwnih       U..l..t.-.l  .  .nl.r.  a|M"ar  ,n  -h,-  ..nl.n 

in.l  |«.-trri..r  ,«.rl.>.n,  ..f  ih.    l««lv  of  Ihr  Nmu-.  m,  ihat  l..r  a  time  itu  r.-  ;,:.    i«,,  ^l,ll,  noi.l  l..n.-.  ,i-  il  u.r.  ,  .,,i.i.,lr,l 

1„M„.I  llu  mhiT.  Ihr  l.-r  vunK.  uHm-  from  .|h..,,I  . ,  ntrr,.  .,.  .L,  ..l-.  ih,'  iin  al.r  «m«^.  ih,  . ,  nl>  r-  f..,  ,!»■  lath  r 
,K,.  i„rmin._'  th.  ,.v„rr  |.l,.t,-,  ..f  th.-  ,.trrvn..i.l  ,.r.«.-w,.  I  h.-  1,-,,  r  « inK^  unit-  v,,i),  ih,  ant.  r...r  .  ml.  r  ..I  ih.  lu..K 
,,f  ih.  .  h..i..i.i  l«-lvvrcn  till-  sixth  an.l  m  v,-nlh  1. 1..I  month-,  ih.-  iir.  :,i,  r  «ini.'-,  .L.  n..i  ui.iU  "Uh  in.  |....|,ii..r  , ,  m,  t 
„„„|  all.-t  bif.h,  an.l  th.-  !«..  hah.,  of  the  t.«ly  of  Ihr  .,.h.  m.i.l  .1-.  .v  .1  unit.-  nnlil  .ifh  ■  l.irlh,  an.l  th.n  I..U  -|..N.h.  ... 
Ill  ll   m  intrrsf-'nrniuiltil  ivm-lnmilro^ir  i-vi^t-*  (or  a  lonn  linn-. 

1  h.  ....  rnal  plate  of  th,  |.|.-rvK..i<l  |ir.«Ts-,  i^  form.-.l  in  m.-ml.r.im-.  i.ut  ..".n  iinil. -  ■ ...  ih.  .  v.  i.th  h  Ial  m..nlh  . 
■viih  the  .■M---.ll  ;.laf-  Th..  -|,h.n.ii.l,.l  Mrhinat.-.l  l..n....  a|.|«-ar  mu.  h  Ial,  r  an.l  .1..  n..i  unih-  vnlli  ih.  U-U  ..I  Ih.- 
-|,h.-n..i.i  until  .!■  ,Mv  oi  ;..l„rtv  ami  ,il  ih.-  vim,  lim,  th.  -,.n.-n..-..  .  i|iilal  ,m,.  h..n.lr..~i-  ,..mm,-„,,.,  1..  ,lK.,|.i..-ar, 
Th.  ^|.l-  ....Mial  siiuiv  an-  .  .luring  .  h.l.lh..-l,  I.ut  in.  n-a-H-«  ,  ,.nvi.l,-ral.lv  i.i  t-M.m  .luring  lat.  r  hh- 

Variation.  ,-,r.-  lm|U.-m  in  th,    si.lunoi.i  l»,n.,  su,  h  as  th.-  ,« ,  iirr.  n. .-  ..f  mi.l.ll.    .  lin..i.i  pp^.-s.--  (m-.-  paR.-    \S< 
nii.l  tlu-ir  hMm  ^-n'    .  .•    anterior  ..r  p,,st.-ri,.r  ,lin.,i.l  pr.«.-s^.s.      11.   ..s.ili.  ..lion  of  ilu    pi,  rv,-..,,.......,     hv;.,n..fit  i  m-,- 

paiP    1  "i    ih.T.-  is  !».,!  mli<-i|ueii(l>-  (..rm.-.l  ..  ptriv.Oifinoin  />r. .,...( />f-,w.'5vi(f  Ciiinin:) 

THE  TEMPORAL  BONE. 

111.   h-mporal  Imhu-  (Figs,  c;^  to  (>V  i-  siluah.l  in  Ih,   ial.  nil  p.:ri  of  ih.   Iia-.   oi  tli,   -kiiil, 
:,ml  loim>  portions  of  til.  middle  and  i«)>te,i()r  iranial  fos-a-.     Ipon  eillu  r  -i.le  ..lu-  ..f  ili.   I.  m 


iw.t  ll  lione-  ("'IN  li.  (he  largi  gap  in  tlie  (»v  hasiuirr  (sir  pages  40  .inil   1; 


I. 


-   51 

I  if 


52 


ATLAS    AND    TEXT-BOOK    OF    HUMAN    ANATOMY. 

p,c    55.-The  right  temiwral  bone  seen  from  the  outer  (lateral)  surface  (\). 
p,P,'   56.— The  right  temporal  Ixme  seen  from  the  cerebral  surface  (j). 


Each  temporal  iK.nc  consists  of  four  portions:   (1)  A  squamous  portion,    (2)  a  petrous  por- 
tion;  (3)  a  mastoid  portion;    (4)  a  tympanic  portion.     The  petrous  portion  ts  also  tcrme.1  the 

^'"m^  squamous  and  mastoi.l  portions  arc  placed  almost  vertically,  while  the  pyramid  is 
practicallv  1  .,ri«.ntal.     At  the  external  auditory  meatus,  the  in.lividual  portions  of  the  tern,x,ra 
rxne    rc'..ouped  in  such  a  manner  that  the  smallest  portion,  the  tympanic  portion,  is  sUuated 
!n  from  of  anil  below  the  auditory  canal,  .he  mastoid  ,K,rtion  is  bc-hind.  the  squamous  portion 
above,  and  the  petrous  portion  inteinally  and  anteriorly. 

THE  SQUAMOUS  POKTION. 

The  squamous  portion  of  the  temporal  tx>ne  (I-igs.  5,^,  .0.  and  57)  consists  of  an  approxi- 
nt.telv  semicircular  '  criical  bmv  plate  which  is  concave  internally  and  convex  externally  An^ 
"  r  V  Trticulates  -  Ki,.  ,.,  and  40)  with  the  temporal  surface  of  the  greater  wing  of  the  sphenoid 
bv  the  sphenos,uamo.,  suture  ^spUenoiM  border),  and  superiorly  with  the  l^-tal  .x.ne  by 
means  of  the  suamosal  suture  i  parietal  harder,  sc-e  page  ,8).  A  deep  notch,  the  parretai  noUl., 
"".mm<Kla.es  the  >phenoid.l  angle  of  the  parietal  Ix.ne  an.l  separates  the  squamous  portion 
from  the  mastoid  iM.rtion,  which  is  situated  inferiorly  and  iK.steriorlv, 

l-he  ..,onJ  proeess  ,Fig.  ,0  springs  from  the  external  surface  o  the  ..uamous  portion 
„f  the  .em,K.ral  In.ne  and  aids  in  .he  formation  of  the  zygomatic  arch,  by  ar,u  uhmng  w„h  the 
temporal  pnxess  of  .lie  /.vgoma.ic  U,ne  by  means  of  the  zy,omali.otemp<.al  su,ure.  1.  .s  alt^o. 
2.onta  a,  it>  origin,  but  later  i,  ro.a.es  through  alK.ut  .p  degrees,  .,  that  it  assumes  a  vertical 
position  and  forms  a  l..nv  pnxess  tlmened  .mm  side  to  side.  Its  ,x,s.er.or  prolongation  alxnv 
the  external  au.litorv  meatus  form,  a  s,. p.am.stoid  rid.e.  which  ,K,stenorly  U'cme^  conl.n.ou- 
Nvi.h  the  terminal  iH.rtion  ol  th(   inicri.r  temi«.rMl  line  (xe  I-ig.  3.)). 

Th.  part  of  the  ..uamous  .H.r.ion  whi.  h  lies  Ix.low  .he  zygoma  forms  par   o-h.-  ..U,n 
surface  of  the  Ix...   of  th,   .kull  and  i^  umscqucntK  almoM  lioruontally  place!  (Mg    ,H)    and 
,„,rdcr.  upon  tlu    infrate,n,«.ra!  surface  o,  ,he  greater  wing  ol  the  ^plum.ul  1-me,     It  is  th.TC  _ 
for.,  advatnageoa.  .0  .ulKliv.de  the  s.,uamou-  ,K,r.ion  o(  tin-  ,em,K,rai  Ik.uc  into  a  larger  .eriteal 
portion  and  a  smaller  hori-.ntal  portion. 

In  tl,..  v.r,i.al  portion  ,1,.  r,  mav  W  re.ogni/ed  an  cx.ernal  t.mp,nal  surjare  and  an  uu  ,,.al 
cerehral  un,,,,.  Mh.  l.m.r  ,.  al,M.nt  in  d,e  horizontal  ,H.r.ion..  The  .em,...ral  .ur  ace  h.rms 
,  par.  of  the  planum  Innporale  an.l  of  the  jossa  /,m/..n;/rv  .see  Fig.  V).,  a>,.l  ..  usuallv  .mm,  h, 
„  ,.,gh  it.  lo'r  po„ion  mav  sometimes  U-  roughened  by  .he  origin  of  the  ,.m,..ral  mus. le. 
I,  present-  a  .hallo.  ,r,«.v.  for  the  middle  ,em,K.ral  artery,  k-ginning  ,,l..ve  ,he  external  audi- 
lor   nieatu.  and  running  up\\aid.  1       •;,  „ 

•    \,  ,u.  i.  .n.  -f  .he  h.  •i^ontal  and  vertKal  parts  i-  -itnated  .he  roof  of  the  external  au.  n„r> 

meatu.  ,.,e  nma.nn,.  .  .1-  >.  ,he  aud.torv  canal  Uing  fonne.1  by  .lu-  tsmpanu  ,x.r„.m,  and 
j„,,  .ilH.v,  ,h..  ev.emal  audi.o,^  meUM..  „  tin  -ransi.ion  into  the  mastoid  ,K,r..on,  .here  is 
fre.iuen.ly  foun.i  .,  -nn'l  b..!n  .p-n,.  ti'v  ^uprammlal  ^pme  ilm.  ^^\. 


f'(in'iii)'  honfir 


(iivnvf  for  iiuild/t  Uini'onil  iirtriy 

I'vinponil  line 

."iin'dii/  iiott'li 
Siipniiiii'iilnl  s/^iiii 


M<i<ti>ut  /(irdiiiru 

Ori'ipildl  boiilir 
(mastoid  portion^ 

Mii^'loid  i^nun-r 
Mii''li'itf  porlion 

Mii-!(inl  piiur^' 


Squamous  portion 

(Iniiponi!  ••iir/'dcc) 


Snhi'ni'iiuil  honlir 


Artiriiiiir  lUiiiuiiir 
1,;.,,,  /     /'f  nvrw'n/tiiiiir  //>-.»/(• 


Tympanic 
portion       '  >''''"'''  niiilifiny  uniitii^ 


I 


I'liiiildl  /'I'lilir 

t'i'fihiii/  ^infill' 


\iriiiiti   riiiiiii:ir- 


SpfltHOiJiU  hof  .<■/ 


Petrnii^  portion 


Siilmri'iiilli'  /I'^vJ 
lilhnitit    iiiltlilor''   iihiitii'i 

lnfi'iiiH   /iiri(>\ii/  t;"':>\'i 


flif'H/ilf     il.^U  If 

I  iiS.    '■>(>. 


^™ 


THE  BONES  OF  THE  SKULL. 


53 


portion,  the  articular  eminence,  vv-h.ch  .s  .1..  parUaU,  '--  ,^  /       ^^^^  ^,^.„,  .Here 
the  zy,on.atic  process  surround  the  --chbu  a    fos-  fr^.n^^  ^^^.^^  ^_  _^^^^^^^,^  ^^^^ 

tremely  ^ou^h  and  sharp,  and,  in  t^e  ^^l)'^™-,;;'  ;;:r;;tl        -       of  t^^  sph.nos„uan,osal 

..uan^osal  suture,  and  it  is  separat.l  '--'-!;:;;;:;^;:Ll/ ,.,.-■.     l.s  cerebral 
usually  even  in  the  adult,  by  a  n..re  or  less  ..s.^.ed  -^u    ,  h    P  ^^  .^^  .  ^.  ^_.  ^^^.  ,^^^^^^,,^,^ 

surface  consists  of  only  a  vertual  I""^'"";  -^';^;^  i^^   "  I  iu,.  and  digiuUe  impressions. 
of  the  middle  meningeal  arter>-,  .Kcasu.nally  exhibits  cereb.al  juf,., 

THE  MASTOID  PORTION. 

The  mastoid  portion  of  the  temporal  ,.ne  ..^s.  .,  to  .S.  ji^ves  U.  na.,e  H^m  t  .  -.  •  ^^^ 
toid  process,  the  mos,  important  structure  of  t^  ,.^u  oH  -  >  ;^^^^^^_^ .^^  ^,^^,,^„,_  |„,,  ,,, 
notch  it  articulates  with  the  masto.d  angle  ot  "^  I--  '^  7;  J^,  .oaifHo'uasWid  su,.^.  ~ee 
..ccipital.x,rcleraraculates.jthd.es,u„,..ru^^^  ..n 

Fi,,.  42).     In  the  lem,H.ral  Ix.ne  U.elt  the  mastoui  iK  „.,,nious  p..rtion;  it  is  se,a 

,;;„;...../ ;...0,  upon  d.pej..us,...,.^  ;,,  ^^,^„  ^^^,  ,,, 

rated  from  the  latter  dunng   ^'.ath    h^    M     sgu  ^^^^^^.^^  ^^^^^^^^  ^.^,^,,.,^^^, 

Incomes  more  or  less  oblit.  rated  .n  later  hU.  J^  ^  ^^^^  ;,,,,,,,,  ,„,,,. 

surface,  which  .n-ars  the  mastoui  process,  an  1  an  -^     '  ^  ^  ^^  ,.,„sid.rable  part  nf 

The  ,u.:.loid  pr..uss  is  a  broad,  conual.  l.n,  ^^^^^  '^^  ^  ;„^.  „„„,,,  „„  ,  ,Ki«. 

U.  mastoid  ,.rtion,  an.i  presents  --!;-;;-;:  ^l,:  ^1  ;:!;;,..  .hue  ,-  a  .>a....ver 

^8).     Internal  tu  thi.  notch,  l^tween  it  a»d  tlu    Kcipn 

jjn„.ve  for  tlv  occipital  artrrv.  „,;,.loid  |,<.rlinn,  i-  the  ma.st.uil 

::;"::;',r;,^r  riJs'i:.:;^..- ■ •• "••■  -- »- 

•^uture.  .  ,  nMii-  ■'  broad  Kr.H.\v,  the  v/,i;»fMW  .1,'r'W 

The  cerebral  .urface  of  tlu  masUud  pnK.--^  '";  ;  .^J'^  „urn..stoid  enu^^arium  ,ri,. 
(see  ,.'.>  F...  4,.).  ^^•hich  usualK  o.mam^  tlu  ;-;;;:;_,,  „,.  ,„..,„;,„  surfa,  e  „f 
S^n     In  ihis  sni.ati.m  the  m-.-toi !  i   •••  -u       o,r.  .tlv 

the  inraniid.  L.wn    i.tlv    duisIohI  oi:     iTis^-.  ')i 

The  mastoid  i.HKCss  .umains  nmup.us  a..   spa>.  ■    L   Avn 


Ik.  .1 


^^  AT1.AS    AND   TEXT  1500K   OF    HUMAN    ANMOMV- 

,,,  „._Thc  ri.h.  ten^poral  Lone  seen  fro.  the  -cerebral  surface  and  fro.  the  apex  of  .he  i^trous 

portion  (\). 
p,£.    c;8.— The  right  tem;.oral  bone  seen  from  below  (1). 
jrj,.    -g  -The  right  temi)oral  bone  of  a  new  born  elilM  (;])• 

Vui  6o.-The  left  temporal  bone  of  ^:yZ:'l::!t'rluL^  ..a.oi.l  ,.,.nion.  vdlow,  a™,  th-  ..M-i. 
In  1-igs.  VI  ami  fra  the  s(|uamous  iwrtion  i»  i;^ .  n,  tnt  p.  ir  )u 

jH)rtion 


ivhiti' 


the  Ixmy  tissue  and  even  expand  it.      lhc\   arc  connciu 
thf  tympi-'itc  antrum. 

<  .^      h;..f  „  ,inu  for  muscular  at-a.hnunt  which  tho  skull  ,,...sesscs,  ami  it  r.<civcs 
Th,.  n.asl..i,l  |,r.H.s>  is  one  of  the  -  hu     ,.  .,n..  for  mu  longisMmus  capitis  n.usdcs. 

„„  i„..r,ion^  ..f  .he  .ern,Klei.lon,as,oi..  and  o,  p..,,...^  .>^  ^^^'^^    Several  ,.„enin«s  may  1.  presen,  in  ,he 
The  mas.,.iu  n,„>l,  «ive.  ..riRin  to  the  posterior  l,en^  o    "  <  ''^  ^^ J^^,  ^^,j  ^„„,,  „,,  „a,u,i,l  i-roce,.  .>  also 

vi,i„i,v  ..f  the  mastoid  foramen.     The  depression  Ixs.de  the  supram.al.l  sp.ne 
called  the  masloiil  /"S.vi 

-    £  PETROUS  PORTtON. 

The  petrous  ,>ortion  or  pvramidt.f  tlu  ten.poral  hone  (Fi,s.  ,6  to  58)  forms  a  port.n.  o. 

.ranial  cavity  and  ^^^ ;^^'';^^^^ '  ^^^'^^^^r    ^^r^^^    -  di^inKuiJhe.l  internally  an 
forwanl  and  from   w.thout  tn.ard.      ^ ';-;;;;;,  ."'^,,^i;,,  ,,,,,,,  ,;.,  there  is  a  superior, 

rrr:;;:  :=:-"-        —  >-  -  ---  -^-- 

an  anterior,  an  11  p-.r^bral  <virf:i'  -s  from  the  external  one. 

thetworemainins^'lxjrdersseiian.tet^  ccrtDrai    uni  ,  i,h  ,h..  tvmi.anic  portion, 

The  netmus  ,>ortio>i  in  the  adult  is  directly  cont.u.ous  external,     a  .ih  the  ^>'^I'^""^^ '' 
an,l         ii^a.  Interior  surfat.  l.rders  u,K,n   the   squamous  pt.t.n  >^-  --  -    /       - 
I-  niL.e  -)  tntl  uiKjn  the  snhenoid.  bone  ^sphvopHrosal  l,ssur,\     Tht       .>■   an.    a,..      "      u 

which  is  emlK'-Lled  in  the  petrous  portion  of  the  hont .     Lpnn  th.     ant 

also  a  small  slit  like  orilKt,  tiic   luuu,  /  ,,,,-,mid  and  to  tbc  foramen 

the  Kreat  superficial  petrosal  nerve  pasM  s  toward  the  apex  of  tlu  psramid 

lacenim  in  a  groove  (Fig.  57)-  •  i;    ,i,  .,-,.  is   i  senmd  smaller  opening,  ihe 

Eternal  and  anterior  to  the  h.atus  --"^   '^      '     .      :f:.  ^he  les.er  superhcial 

petrosal  nerve,  u  hit  ii  alst,  passes  forwani  to  ihe  region  o.  tne  ltd... - 


Squamous  port/on  (n-relmil  siir/'iint 
Z\'goinatic  process 


Tegmeii  fornmen 


I'llivsqiiiimosal  fissure 

Aperture  of  super,  tvm/innie  carmluulus 
( ■  groove  far  itunll  ^uperj.  prtro^ol  nerve} 

MiisciilotiilKir  Cdiiiil 

Inlermil  orifiee  of  eiiri'tiil  eiliiill 
lmi're>^i:>  trii^emini 

Pyramid 


(irome  for  i:mi:  superl.  petn'<nl  time 

fliiilii-.  Itilhiipii 


Fif:.  57. 


I'drietiil  notch 


Mastoid  portion 


Muiioid   Sifiiiioiil  i;roov( 
Arcuule    fonimen 
SllluirCIHtte  lOSMl       rmmeme 


/v^oiiHitic 
proces\ 


Articiiliir 
emitieiicc 

Miinitioii''!'-  lo^^ii 
l\'!rorv"i;'>rnii   fi^^ure 
1  'iii;iniil  firocc^s 
I  \l.  (iiiilfterv  nieiitii^ 


•S/r/i'/i/  /i«i(V 


.lf(/^^l/l/   /"I'll". 

M(C-l(ii(f  ".''(iiii'i 

<inhH-e  lor  occipitiil  iirl. 

.\\n\toiil  foniincti 


S/i/iciioi(liil  border  Si/iiiiiiioso 

'■"'.'""'' '""f"  mostoiti 

4'^^  Wuseulotulmr  e,w„l  ^,,,„,.,. 

'•         '•  liil.orilieeoleiiroiiileiiiiiil  -^ 

'^'^  .  l/'(  I  of  pyramui        j 
^t-    X,   /  <Y.  orilUe  of 
'    •'-^«^    etirotiil  etiriill 


f  iieolieolvifipiliut 

euriitt 
l-elro.,:!  /,p>-.; 

/  \t    ,1/xiriiie  ot 
inpntedintti^  eoetlleih 
Inlrniilgnlnr  /vv.,  s- 
\l,l~to:il  riimilhiiliis 

flll^llllU      fO-'^il 

l\lomii~toi,l   loniiiii  II 


( )ccipit(il 
horilcr 
(mastoid    's^ 
portion) 


I  ii^.    'i!A. 


I 


!• 


■i\m 


I  ii'.  00 


THK    nONF.S    OF   TIIF.   SKUI.I.. 


The  rather  thin  Ixmy  plate  of  the  petrous  i)ortion  whieh  form-  'he  anterior  surface  of  llie 
pyramid  between  the  hiatus  eanahs  facialis  and  the  arciiate  eminence,  and  which  extends  to 
the  ])etros(|uamosal  fissure,  is  the  roof  of  the  nii<ldle  ear  or  tympanic  cavity,  and  is  called  tlie 
Ivgimn  lyinpani. 

Near  the  ai)ex  of  the  |)etrous  portion  the  anterior  surface  exhibits  a  depression  of  xaryini; 
shape,  usually  but  a  slijjht  excavation,  which  is  known  as  the" /r/> )«/)«(/  impression  [V'v^.  571 
and  l(xlj;es  the  semilunar  ((iasserian)  f;anf,dion  of  the  trif^eniinal  nerve. 

The  sui)erior  Ijorder  of  tin  ramid,  which  separates  the  two  (irebral  surfaces  from  each 
other,  shows  upon  its  surface  a  shallow  furrow,  occasionally  emi)hasized  by  pronounced  elevated 
marf^ins,  the  superior  petrosal  i^nxnr,  which  empties  into  the  siijctnoid  ^roo\i'.  Like  the  latter, 
it  contains  a  sinus  of  the  dura  mater. 

The  i)ostcrior  cerebral  surface  of  the  jietrosal  ]K)rtion  is  almost  vertically  ]ilaced  and  torir> 
a  portion  of  the  posterior  cerebral  fossa.  .\t  al)out  the  middle  of  the  ])yramid,  nearer  the  superior 
than  the  jiosterior  Ijorder,  it  exhibits  an  api)roximately  round  openin},',  the  inleriial  nudilory 
jortimeu  (Fi^'.  56),  which  leads  into  a  short  canal,  the  iuleriuil  uiulilory  menliis,  which  lodges 
the  facial  and  auditory  per\is. 

.\l)ove  and  somewhat  external  to  tlii-  ojieninK  -"t'  immediately  Ixlow  the  lK)rder  of  the 
])etrous  portion,  there  is  a  dejiression,  the  suluimmle  jcssn  il'ii;.  501,  the  conca\ily  of  which  is 
(iirected  toward  the  ai)ex  of  liie  pyramid.  Sometimes  it  is  bul  sliuhlly  marked,  thouf,'h  it  is 
distinctly  dcyeloped  and  very  larjie  in  the  infantile  skull;  it  contains  a  pnKcss  of  the  dura  mati'r. 
Helow  and  external  to  it,  and  al  :ibout  tiie  level  of  the  orilicc  of  the  internal  meatus,  there  is  a 
slit  like  oril'ice,  the  external  aperture  oj  the  aqiKrihultts  vestihuli  {V'v^.  =;()),  which  is  open  exter 
nally  and  below,  and  accommo;!aies  a  process  (tiie  d\ictus  endolym|ihaii<  u-;  of  tlie  membranous 
ear.*  In  the  vicinity  of  the  anterior  )  )riion  of  the  posterior  lH)nlcr  there  i-  a  cjuite  shallow 
j,'rooye,  the  injerior  petrosal  i^roov,  il'i^.  5(11.  which,  ii>i,'ethcr  with  a  simii.irly  named  j^roovc 
of  the  (KTii)ital  Ixme,  forms  a  channel  in  tiie  petro-occipital  fissure  for  the  inferior  petrosal  -inu- 
of  the  dura  mater  isee  also  I'ii,'.  |;i. 

The  |M)sterior  Ixirder  of  the  |i\  ramid  is  separated  from  tiie  ociipital  Inuie  {the  ba-ilar  .ind 
lateral  [Kirtions)  bv  the  jielro  occipital  tissiire  and  the  jufiular  foramen.     It  iireseiil-  the  iiii;iitar 
notch  (Fij;.  ti(>),  (iirres]!ondin),;  to  the  similarlv  named  notch  of  tlie  cKcijiital  l)one,  and  also  ii>u 
ally  an  intrajiif^ular  process  isee  jiage  4(1^. 

The  anterior  Ixirder  is  sejiarated  from  the  ba-e  of  the  ,i,'reater  wini;  of  the  s|.lunoid  hone 
bv  the  sphenopetrosal  fissure  and  by  the  joramen  lacerum:  the  apex  oj  the  pyramid  i-  in  ((Mii.ut 
with  the  lateral  surface  of  the  Ixnly  of  the  sphenoid  lionc-.  At  the  foramen  l.uc  rum,  1  lose  to 
the  actual  a]H'X  of  the  jiyramid,  there  Is  an  irregular  opening;;,  the  intirnal  lamiiil  joramen  >■,'. 
57),  which  leads  into  the  carotid  canal,  a  short  canal  which  Iraveisis  tin-  iii.u  r  h.ilf  of  du  pc!rou> 
portion  of  the  temporal  Iwine  and  IcKlj^es  the  internal  carotid  arfcrx . 

Kxternal  to  the  inleriial  carotid  foramen  i>  situate<l  the  ciitr.mci  io  a  canal  whiiii  passes 
into  the  middle  ear  iH'neath  the  lej^men  tympani,  the  mustuloluhar  lanal  il"\^.  ^- K  -11  i.illed 
Inrause  it  contains  Ixtlh  the  tensor  t\iiipani  muscle  and  tiie  lui>taclii.in  tulu-  i-ee  also  page  si  I. 


5 


i  <  I 


•A  unmvi-  nin^  (nun  llu  rMirii.il  .ijmiiuh'  "I  llu  .ii|U.iilui  ici^  m-iIKuIi  !•■  iIh  juciul.ir  rwilili. 


56 


ATLAS   AND   TEXT-BOOK   OF    HUMAN    ANATOMY. 


Fig    6i  —The  left  temporal  bone  dividerl  through  the  axis  of  the  petrous  portion  (J). 

Fig  62.-The  right  temiwral  bone  divided  in  a  plane  passing  through  the  external  auditory  meatus  and 

nearly  parallel  to  the  axis  of   the  i)etr()us  jwrtion   (i). 
Fig    6,  -The  right  temporal  bone  divided  in  the  upp-r  half  through  the  axis  of  the  jKtrous  ,»rt.on 

and    iK-low  horizontally,  the  wall  o."    tne  canalis  musculo-tubarius  beuig    partly  chiseled 

away  to  show  the  septum  (]). 


In  this  situation  the  spine  of  the  sphenoid  insinuates  itself  into  the  angle  Ix'twccn  H'o  anterior 
border  of  the  pvramid  and  the  cerebral  surface  of  the  scjuamosal  portion,  so  that  the  groove 
for  the  Eustachian  lube  (see  page  51),  running  ui>cn  the  inferior  surface  of  the  sphenoul  bone, 
leads  into  the  orifice  of  the  musculotubar  canal. 

The  external  surface  of  the  petrous  portion  forms  part  of  the  external  surface  of  the  base 
of  the  skull.  It  presents  quite  a  numlxT  of  noteworthy  structures  and  is  the  roughest  ami  nu,st 
uneven  surface  of  the  bone.  At  its  junction  with  the  mastoid  portion  there  is  a  rounded  opening, 
the  slylomasloi,l  joraw.n  (Fig.  58),  the  external  orifice  ..f  the  jacial  canul,  which  traverses  the 
temiHjral  bone  in  a  curve  and  Uxlges  principally  the  facial  nerve. 

In  front  of  the  stvlomastoid  foramen  is  situate^.!  the  slyloid  proa-ss  (Figs.  55  and  58),  the 
remains  of  one  of  the'  bran(  liial  arches.  Sometimes  it  is  short  ami  thick  ami  sometimes  it  is 
ven-  long*  and  it  is  usuallv  place.!  in  a  sort  of  lx)ny  sheath,  the  vuaiml  process  (Fig.  55). 
which  is  mainlv  in  contact  with  the  pr<xess  anteriorly  and  Ixlongs  to  the  tymiuinic  jiortion. 
The  styloid  pnxess  gives  origin  to  three  muscles  (stylohyoi.ieus,  styloglossus,  and  slylopharvn- 

Rt'us)-  ft-  1     1 

To  the  inner  side  of  the  slvloi.l  process,  toward  the  posieri-.r  lx)rder  of  the  pyramid,  there 

is  a  roumled  or  an  o\al  «iepression,  the  JHt^ulxr  jnssa  (Fig.  ^l„  which  borders  uiK.n  the  jugular 
notch.  It  lodges  the  upp.  r  extremity  of  the  internal  jugular  vein  (bnllms  vcmi-  pif;ularis  upcnor), 
and  at  the  Ijottoni  of  it  a  small  canal,  ihe  iwisloi,!  tanaliailus  (see  page  58),  bc-gins  as  .  groove. 
Near  the  jugular  fossa,  toward  tlie  apex  of  the  pyramid  and  close  to  its  posterior  U)r(ler,  is  situ- 
ated the  small  funnel  like  orificr  oj  llir  nqwidiutus  (uvuilkulns)  anhlar  (Fig.  58). 

IkhimI  the  jugular  fossi  and  internal  to  tlie  stvlomastoid  foramen,  the  j.osterior  border 
of  the  pvrami.1  presents  a  somewhat  roughened  suiI.hc  for  articulation  with  the  oc<  ipital  lx)ne. 
In  front  of  the  jugular  fossa  and  separated  from  il  by  a  narrow  ridge,  there  is  a  large,  almost 
circular  foramen,  tlu  .xUrnal  carotid  jnramm  (Fig.  5,81,  which  lea.is  into  the  carotid  canal,  tlie 
|K.slerior  wall  of  which  presents  a  numlxr  of  small  foramina,  the  external  orifices  of  the  uiroluo- 
Ivmpiiiiic  cut  ilicii'i,  for  the  nerves  of  llie  s;ime  name. 

lietween  the  external  .arotid  foramen,  the  jugidar  fos.s;i,  and  tlie  external  orihee  of  the 
a.|ua-ductus  cnhlea',  there  is  a  small  ami  sometimes  iKx>rl>  marke.l  depression,  the  p.ln>sal 
jo^s.1  (Fig.  581,  which  (..mains  the  inferior  aperture  of  the  tympanic  canaliculus,  which  trans- 
mils  the  tvmi)anic  nerve,  internal  and  anleri.ir  lo  the  external  caroti<l  foramen,  ami  towanl 
the  f..ramen  huerum  there  is  a  roughene.1  surface  f.-r  the  origin  of  the  levator  veil  i-alatini 
mu.scle. 

*  Thr  pr<H.ss  .m  tin-  trm|H,r.l  >«.n.  is  fn  .|mn.l.v  .|Uiu-  short,  1ml  it  may  U-  <  .mt.nm.l  as  a  In.ny  s|m>  uI.  in  .i..-  .ijio- 
hyoid  ligament  («»•  pag<-  iii)i. 


Ext.  srmiciir.  rniuti 
Sii/tii:  sriiiinirii/(ir  i niuil 
['/■■itil'ii/i 
liitfnnil  iiiulilorv  tit 


i'acial 

caiiiil 


m.^ 


^•L 


('tiiotid  aiitiil 

rvtiiptiitt'i-  (intnitii 

Stylo/It 


Mif-li>i(f  (v//.s 


n<,r.  01. 


i-l  Ml 


txtiriKii  aitiltttvy 

IttC.tttts 


.\lii<t:i'<l  rxtifti.il 

iclh       siittic.     Sitpcrior  srtiticitriildr  aiiiiil 
I'itniil  , .     .,    , 

I  islthtilf 


I'lVttioiitory 

litlmtal  (itiditorv  iitritlif< 
('(xii/i'd 


Intiiiiiil  inifiiv  01  ciiivriil  iiiiiiil 


Slyhiiil 


l\'iti/>iitii(' 
(tttlniJii 


CitlVtiil   I'dlllll 


I V'lipnittc  attHiiiit 


ni'  III 


.l/(/,s7ii/i/  iii/'i 
'        ,'  .\trtiitfr  nititii till 


I  niiiiinii'  I'ltr  fnciii!  rattnl 
I'lWtionloiy 

<\i:olt,     iiittill 


I  \r>iiiii/  iitiilitiK  V  ntriittf- 


I    XllTlllt/    I'll/iff    III 

i;tr       '  iiitiiil 
\\ii-itili<tiil>i,i   iiiitiil 


y 
i 


THK   BOXES   OF   THE   SKULL. 


s: 


The  anterior  portion  of  the  external  surface  of  the  [)yrami(l,  the  fjreater  |)art  of  wliiili  is 
concealed  by  the  tympanic  i)ortion,  forms  the  inner  wall  of  the  cavitv  of  the  middle  ear. 

THE  TYMPANIC  PORTION. 

The  tympanic  portion  (Fij^.  sO  i^^  a  small,  slightly  curved  portion  of  the  'emporal  lx)ne 
which  Ijecomes  secondarily  adherent  to  the  remaininjj  jx)rtions  and  is  represented  in  the  new 
Ijorn  by  a  simple  ring  open  aljove  (Fij^.  5()i.     Outf^rowths  from  this  ring  fomi  liie  anterior, 
posterior,  and  inferior  walls  of  the  external  auditory  meatus,  l\-    orilii      'f  thi  ,  and  the   outer 
wall  of  the  tympanic  cavity.* 

A  process  of  the  tegmen  tympani,  the  itijirior  process,  is  ])ushe(l  in  Uiueen  the  s(iuamous 
and  tympanic  jwrtions  internally.  It  is  lx)unded  upon  ■■  -.e  side  by  the  pre\iously  mentioned 
petrosf]uamos;d  fissure,  and  u])on  the  other  by  a  second  grof.ve,  the  pdrolymponh  or  Gltisi/ian 
fissurf,i  Ixith  of  which  unite  to  form  the  lympaiiostjuamosal  fissure.  The  tympanic  ])orlion  is 
separated  from  the  mastoid  |)ortion  iiy  the  lympanumastoid  fiysiire,  which  contains  the  outlet 
of  the  mr.'toid  canaliculus.     The  tymuanic  jxirtion  also  forms  the  Tiiginal  process  (see  page  5()). 

.•\t  the  inner  I'xtrrmily  of  thi'  cMcnial  ■„  .ililnry  nualus,  lowaril  ihc  l>ni|aniin;,  iliiri-  i-  a  lirdilar  iinnvi.  ilu-  lyni- 
panic  i;ro(Ke,  iinly  tln'  uppiT  c,ua(lrant  <i{  which  is  wanting  1 1.  c,  ihr  inirlinn  (if  \hv  (>niii\c  nut  fciriniii  li\  ihi-  lun|iariii 
I'cirlion).     This  pr<HnT  (»ivi's  attaihmcnt  to  the  tympanii   mi'iiliraiu-. 

At  thf  margins  t>f  the  jrroovf.  and  (f»nsf(|ucntly  of  the  tynipanir  \n\:  rioii,  ihtrc  arc  I\vo  sniall  lion\-  spii  ulrs.  known 
as  the  qrriittr  and  lesser  spines,  and,  furtherniore,  in  this  situation  t'nTe  i>  a  noti  h  iK-twfen  the  tympani)  portion  and 
the  upper  wall  of  the  meatus  whi(  h  is  furnisher!  !)y  tlie  s<]uanious  p«  rtion ;    iltiv  i^  i  ath  d  tbi  txwptniu  unhh 

THE  MOST  IMPORTANT  CANALS  OF  THE  TEMPORAL  BONE. 

In  the  temporal  Ijone  there  is  a  scries  of  tanals  wliirli  transmit  \essels  oi  nerves,  or  usuall\- 
vessels  and  ner\es  together.     The  most  important  of  t!'  s    are  the  following: 

The  jacidl  canal  (Fig.  fii)  contains,  in  addition  to  !)lo<Mi-\essels,  tlic  seMtilh  cranial  nerve, 
the  facial,  which  g.ves  olT  two  branches  during  its  coi'.rse  in  the  temporal  bone.  Tlie  .an;i'  nia\ 
be  divided  into  three  portions,  which  are  placed  appi'oxiniati  Iv  at  rigiil  angles  to  taih  otlitr, 
so  that  the  cinal  is  bent  upon  itself  in  two  sitiiaiions.  'I'he  Inst  I\mi  portions  of  tiic  canal  are 
horizontal,  the  las   one  is  vertical. 

The  first  por.ion  of  the  ca  ;  •'  rims  from  the  internal  auditory  meatus  to  tile  lialiis  r..l!o|,ii, 
and  therefore  almost  n'  right  angles  to  thi'  axis  of  tiie  pyramid.  The  sitonc'  portion  begins 
at  the  hiatust  an  '  lies  almost  exactly  in  the  axis  of  the  pyramid  in  the  inner  wall  .if  tile  tynipanuni 
{panes  labyrinthica),  atx)ve  the  so  called  jeiieslni  ovalis  ijeiies/ra  vestihuli\.  Tlie  tanal  finally 
bends  verticallv  downwani  (at  the  pyramiilal  eiiiineiicc  of  the  t\m|)aniMii)  and  terminates  at 
the  stylomastoid  foramen.  Just  before  its  termination  it  gives  oil  a  canaliculits  cliordic  lyiiipaiii, 
which  pas.ses  oblitiuilv  u])war.l  and  forward  to  enter  tiie  tym]ianum.  It  transmits  a  l)raiuh  of 
the  facii'l  ner\e  known  as  liie  iltonla  tympani,  whiiii  traverses  ilk'  tvnipanuni  and  it  axis  this 
cavity  through  tin-  petroiymj.anic  fissure. 


it 


i 
I   i 


t   i 

!! 


i  ■ 


*  ( >n  ;im»uni  nt  ihcir  rcialiiMi  In  iht'  scn-^t-  of  hcarirm  ihc  remaining  -irudurc'^  {lavitif 
thf  ptirnus  portion  \\\\\  N-  (on^iilcnd  in  <|i  tail  in  \hv  scitii'ii  upnn  nrj^an^  «>f  spn  i,|  ^t-HM', 

rate  foramina. 

J  Tht    U'nd  of  the  (anal  in  ihis  situation  i>  lalhd  llu    i^fuUulum  c/  thr  /,ni,jl  iutial. 


(  anal-,  *  ti    i  s'tuali'i  in 


58 


ATLAS    AND   TEXTBOOK    OF   HUMAN   ANATOMY. 


Fk;.  64.— The  outer  surface  of  the  riijht  parietal  Ijone  (i). 
Fig.  65.— The  inner  surface  of  the  rij^ht  parietal  hone  (4). 


While  the  facial  canal  is  the  longest  of  the  canals  of  the  petrous  portion,  the  carotid  canal 
(Fics.  6t  to  63)  is  the  widest.  It  is  al.so  Ix'nt  at  a  right  angle.  It  commences  at  the  external 
carotid  foramen  u|)()n  the  external  surface  of  the  petrous  jiortion  of  the  temporal  and  passes 
at  first  almost  \erticalh-  upward,  in  ct^ntact  with  the  anterior  wall  of  the  tympanum;  in  the 
immediate  vicinity  of  the  c  chlea  it  bend.s  at  a  right  angle  and  then  runs  almost  horizontally 
in  the  axis  of  the  ])yramid  to  reach  its  irregular  and  frequently  incomplete  superior  orifice  at  the 
aj)ex  of  the  j)ctrous  portion.  Fine  canals,  the  carotkolym panic  canaliculi,  lead  from  the  carotid 
canal  into  the  tymjjanic  cavity. 

The  mtisculoliibar  canal  (Fig.  6;,)  runs  jiarallel  to  the  carotid  canal  and  in  such  immediate 
proximity  to  it  that  jiortions  of  lx)th  canals  have  a  common  wall.  It  begins  at  the  inner  side 
of  the  apex  of  the  i)etrous  portion  of  the  temporal  bone  upon  the  anterior  border  of  the  jiyramid, 
between  the  jjctrous  portion  and  the  horizontal  jjart  of  the  squamous  portion,  and  runs  aj)- 
I)roximately  in  the  axis  of  the  pyramid.  .\n  incomjilete  horizontal  septum  which  proceeds  from 
the  inner  and  j^osterior  wall  (Iwrdering  ujjon  the  carotid  canal)  separates  an  upper  smaller 
compartment,  the  semicanal  for  the  tensor  tymjjani,  from  a  larger  inferior  one,  the  semicanal 
lor  ti.  ■  Eu.stachian  tulx';  lx)th  compartments  have  their  exits  in  the  anterior  wall  of  the  tym- 
panum.    Tlie  canal  contains  the  tensor  t_\Tnpaiii  muscle  and  the  Eustachian  tube. 

The  tympanic  canaliculus,  for  the  nerve  of  the  same  name,  proceeds  from  the  ])etrosal 
fossa,  and  at  first  passes  vertically  upward  into  the  inferior  wall  of  the  tvmpanum  to  be  con- 
tinued as  a  groove,  the  ,?mnr  oj  the  promontory,  upon  the  inner  wall  of  the  tympanic  cavity. 
It  then  leaves  the  tymjianum  as  a  canal  jjassing  from  its  upjier  wall  to  the  sujxTior  aperture 
of  the  tympanic  canaliculus  on  the  anterior  surface  of  the  petrous  ])ortion,  where  it  rommunicates 
with  the  cranial  cavitv. 

The  mastoid  canaliculus  Ixgin^  in  the  jugular  fossa  as  a  groove,  crosses  the  lower  jjortion 
of  the  facial  canal  at  a  right  angle,  ,ind  terminates  in  the  tymiianomastod  fissure.  It  transmits 
the  auricular  branch  of  the  pneumogastric  nervc'. 

In  adcliiif.n  l,j  ti,  .lir-rrlls  of  the  rna.stui.l  pro.,  s,  i|u'  tomixiral  txino  also  loiuaiiis  a  larger  eavily,  the  lyvipanic 
.iiitnim  (Kig.  (),).  (For  a  d.laileil  desrription  see  the  ^peiial  sense  organs.)  'this  is  in  conneelion  with  the  mastoid  cells 
behind  and  with  the  niuseulotubar  >anal  in  front.  It  is  not  separated  from  the  evKrnal  auditory  meatus  1)V  osseous 
tissue  liul  only  l)y  nienihrane. 

In  the  devel.ipment  of  the  temporal  Ixme,  the  jH'trous  portion  antl  the  mastoid  prcKess  are  developed  in  (cmimon 
from  the  cartilapn.ms  auditory  vesicle,  and  the  squamous  and  tympanic  (xirtions  are  added  later  as  supplenuntarv 
l).mes.  The  styloid  process  has  no  eonnertion  whatever  with  the  remaining  portions  of  'he  temporal  Ixme  and  arises 
from  a  jxirtion  of  the  branchial  skeleton. 

CommcniinR  at  the  Ihinl  fetal  month,  ses.ral  .enters  appear  in  ,hc  cartilaginous  auditory  vesi.  le  an<l  subse.iuenilv 
unite  to  foni.  a  common  origin  for  the  pelr.ius  and  mastoid  portions.  The  latter  is  not  ilistin.  llv  developed  even  at  birth; 
a  mastoid  pro.  ess  gradually  forms,  but  it  is  n.it  dislina  until  late  in  childhood.  The  first  center  ..f  ossill,  ation  for  the 
-.quamous  portion  appears  toward  the  end  of  the  second  fetal  mr.nth,  and  the  tympanic  |M>rli..n  ossifi.'S  at  about  the  same 
time  as  the  nvramid 

In  tbv  temporal  Ixme  of  the  new-born  (Fig.  501  the  tympanic  portion  has  the  shape  of  a  ring  ..pen  alx.v,-,  and  is 
known  as  th.-  „<inuli,s  lymp.muu^:    it  is  at  first  merely  r.ttached  to  the  remaining  Ixmes.     .\  very  distin,  t  suture,  the 


Piiriital  foninun 


Si/n;il/(il  border 


Occipital  uni^le 


( )ccipitii! 
border 


I  rotiliil 

llll''lc 


Siii'i  rii'r  riirti\)nil 


l'i>iru>r   'ifi/'t'iiii 


I  roil  III! 
Ihiidcr 


I  nr.  04. 


"^plhlioidill 
(lll''lc 


i  r 


Mii^toid  (iiioic  Si/iiiiiiiosid  liortlcr 

Sni'ittut  border 


I'iiriclii!  foninicii 


I'roiiliil 
(iii<;lc 


f  roil  til/ ^ 
border   \ 


Spill  iioidill  iii.ob 


Siii^iitiil  i^roovc 
<  Iccipildl  iiiii;!e 


Sulci  (irteinf-i     Si/tuiiiioyiil  lioider 


►,     ,   Ociipiliil 
hordir 


I  ill.  <n- 


\     Mii^toid  limbic 
Sitiiiioid  L;roo\< 


|1  'f        1 ' 


f    1 


I    I 

i    t 


^•Si  -  :. 


THK   BONKS   OF   THE   SKULL. 


59 


squamosomastoid  suture,  indications  of  which  may  he  visihh-  in  :uluh  lifo,  sqiaratcs  ihi-  sf|uam<iii>  fmni  the  mastoici  jHir- 
tions.  The  hone  also  varies  considerably  from  that  of  thi  ailull  in  other  respects,  ahhoURh  all  the  portions  an'  already 
united  by  osseous  tissue.     I-.spec  iaily  large  in  the  new-born  is  the  subareuale  fr>ssa 

During  the  first  years  of  life  the  tympanic  porlion  develops  by  the  growth  of  the  annulus  tympanic  us  lo  a  trough- 
Uke  structure,  and  it  is  as  the  result  of  this  growth  that  the  bony  meatus  is  formed.  There  nevertheless  remains  a  .on- 
stant  unos.sined  portion  o?  the  inferior  wall  of  the  meatus  (Fig.  Oo),  which  usually  doses  in  during  the  fifth  vcar.  The 
mastoid  proces;,  iH-comes  distinct  at  this  time,  but  does  not  ccntain  air-cells  until  the  time  of  puberty. 

The-  styloid  process,  ari.sing  from  the  second  cartilaginous  branchial  arch,  l.^sil"les  l.ile  and  sul>ser|Uently  beo.mes 
connected  with  the  temporal  bone. 

THE  PARIETAL  BONE. 

The  parictrl  bone  (Figs.  64  and  65)  i>  a  topical  Hat  Ixinc  which  arises  from  the  membranous 
cranial  cap.sule  ant!  is  not  jjreformed  in  fiiniiage.  It  is  one  of  the  simplest  of  the  cranial  Intnes, 
is  distinctly  (]uadrangular  in  shape,  and  is  markedly  curved  lx)th  in  the  sagittal  and  in  the  frontal 
direction.  It  presents  for  e.xam.ination  U\n  surfaces,  an  external  convex  paricia!  siirjarr,  anil 
an  internal  concave  cerebral  surjace. 

The  four  borders  of  the  Ixine  are  named  rcspecti\ely  the  jnmlal,  the  sdi^illnl,  the  oeeipilal, 
and  the  squamosal  Jxjrdcr,  and  by  them  the  Iwne  articulates  (Figs.  ,:;8  and  40)  .11  the  coronal 
suture  with  the  frontal  bone  by  its  frontal  border,  at  the  s[)henoparietal,  .sf|uamosiil,  and  jjarieto- 
mastoid  sutures  with  the  greater  wings  of  the  si)henoid  and  with  the  temporal  l)one  by  the  stjua- 
mosal  border,  and  at  the  lambdoid  suture  with  the  (Kcipital  Ixtne  by  the  (xcipital  torder.  In 
the  sagittal  suture,  the  s;igittal  lx3rders  of  Ixith  parietal  Ixjnes  articulate  with  each  other  (Fig. 
46).  The  anterior,  superior,  and  posterior  margins  are  markedly  serrated,  ( orresponding  in 
character  to  the  sutures  isiiturcp  serraltr);  the  inferior  margin,  however,  is  lK\elec!  and  its 
external  surface  is  overki'  ,ii  the  squamosal  suture  by  the  mari,'iii  of  the  temjjoral  lx)ne.  The 
four  angles  of  the  bone  arc  the  jronlal  aiii^le,  the  anterior  superior  angle,  formed  by  the  coronal 
and  saguial  sutures;  the  splieiwh  I  aui^h;  the  anterior  inferior  angle  at  the  s])henoi)arietal 
suture;  the  occipital  angle,  the  posterior  superior  angle,  formed  by  the  sjigittal  and  lambdoid 
sutures;  and  the  mastoid  angle,  the  jiosterior  inferior  angle,  at  the  ])arietc)mastoiil  suture,  lilling 
out  the  parietal  notch  of  the  temporal  lx>ne.     The  most  acute  angle  is  the  sphenoidal. 

The  external  or  parietal  surface  (Fig.  64)  presents  at  its  point  of  greatest  curvature  the 
parietal  eminence.  Relow  this  nn  the  superior  and  iiijerior  temporal  lines  (see  also  Figs.  t,i) 
and  40),  the  latter  Ix'ing  much  more  distinct  than  the  former.  Relow  these  lines  the  external 
surface  of  the  iiarictal  tone  form.T  a  portion  of  the  planum  temporale  (see  Fig.  31;). 

In  the  vicinity  of  the  sagittal  suture  and  near  its  posterior  extremity  is  situated  the  pariet  ' 
joramen,  a  so  called  emi.s.sar>-  foramen.  ;ximctimcs  the  internal  and  sometimes  the  external 
nrilice  is  wanting;   the  fonncr  leads  into  the  sagittal  gnxive. 

The  most  striking  structures  upon  the  cerebral  surface  (Fig.  65)  are  the  extensive  grooves 
for  the  l)l(xxl-ves.sels,  sulci  artcriosi,  of  which,  as  a  rule,  there  is  a  well-marked  anterior  and  a 
less  pronounced  posterior  one.  They  are  for  the  branches  of  the  middle  meningeal  arler>-  and 
are  accurate  moulds  of  these  vessels.*  The  cerebral  surface  also  exhibits  two  other  grooves 
which  acc<>mino<late  wnous  .sinuses  of  the        -n  mater  (s  t  al.=o  page  44);    tiie  sagittal  Ix.rdtr 

*  Much  more  rarely  uilri  veiiosi  also  occur.  On  the  other  hand,  the  >.mmcr  cernent  of  the  sulcus  arteriosus  is 
not  infnc|uently  converted  into  a  short  canal  l>y  a  biidge  of  os.seous  tissue  (>cc   I-jg.  65). 


i  . 


\ 


II 


6o 


ATLAS    AND   TEXT-BOOK   OF    HUMAN   ANATOMY. 

Fig.   66.— The  frontal   bone  seen  from  in   front   (4). 
.  (G.  67.— The  frontal  bone  .-cen  from  behind  (i). 


presents  one-hall  of  the  sagitlal  gromr,  while  the  mastoid  angle  contains  a  small  portion  of  the 
sif^moid  gromr  (see  also  Figs.  4.:!  and  44)-  Digitate  imi)ressions  and  cerebral  jiiga  likewise  occur 
and  granular  jnrokr  j^ranularcs  {Pacchionian  depressions)  are  still  more  common. 

The  parietal  iK.ne  ilevel.ips  in  meinl)rane  in  the  thinl  :  \a.\  month  fnmi  .1  renter  of  (>ssifir;itiim  situated  in  the  pari- 
etal eninenee.     I-.ven  in  the  new-lxjrn  the  bonv  tralxeulie  show  a  distinit  radiation  from  this  point. 

THE  FRONTAL  BONE. 

The  frontal  Ijone  (Figs.  66  to  69)  consists  of  a  vertical  a'  hcd  portion  and  of  a  horizontal 
portion.  The  vertical  ])ortion  Is  known  as  the  jrontal  porlion  and  the  horizontal  portion  is 
composed  of  two  orbital  plates,  and  a  small  median  nasal  portion.  \v  the  orbital  margins  the 
horizontal  and  vertical  ])ortions  become  continuous. 

The  frontal  portion,  the  main  jxirtion  of  the  entire  Ixine,  articulates  in  the  coronal  suture 
with  both  paiietal  Ixmes  by  its  parietal  border  (Figs.  3<)  and  40)  and  in  the  sphenofrontal  suture 
with  the  greater  wing  of  the  sphenoid  Ijone.  It  forms  the  entire  frontal  porlion  of  the  cranial 
vertex  and  presents  two  surfaces  for  examination,  an  external  'jrontal  surjace  and  an  internal 
cerebral  surjace. 

The  jrontal  surjace  (Fig.  66)  is  m..rkedi\-  convex  in  lx)th  the  sagittal  and  the  transverse 
direction  and  i)resents  some  distance  above  the  orbital  cavities  two  feebly  projecting  flattened 
elevations,  the  jrontal  eminences.  Immediately  alx)ve  the  orbital  margins  and  parallel  to  them 
are  two  slighllv  ])P  jecting  ridges,  the  superciliary  arches,  the  develojjment  of  which  varies  con- 
siderably in  dilTerent  individuals;  the  Hat  area  between  these  two  ridges  is  called  the  glabella. 
The  remainder  of  the  external  surface  is  sm(K)th,  although  there  may  be  a  slight  roughening 
in  the  median  line  which  represents  the  remains  of  the  original  jrontal  or  metopic  suture. 

The  supraorbital  border  is  situated  at  the  junction  of  the  vertical  with  the  orbital  plate.  .\ 
]>ortion  of  it  is  furnished  by  the  zyi^omatic  process  of  the  frontal  Ume,  which  also  forms  ])arl  of 
the  external  orbital  margin  and,  in  the  latter  situation,  articulates  with  the  frontosplieaoidal 
process  of  the  zygomatic  bone  in  the  zygomalicofrontal  suture  (Figs.  37  and  ,^S).  The  temporal 
line  commences  at  the  zygomatic  process  and  separates  the  frontal  surface  of  the  frontal  portion 
of  the  Iwne  from  the  small  temjjoral  surface,  the  latter  surface,  almost  in  the  sagittal  i)lane, 
fomiing  a  portion  of  the  planum  temporale  and  being  that  ])art  of  the  frontal  tx)ne  which  bordi 
ujK.n  the  temporal  surface  of  the  greater  wing  of  the  sphenoid  bone. 

Immediately  alxne  the  sUf)raorbital  border  there  are  foramina,  which  may  be  represented 
h\  notches  of  var>ing  depth  in  the  border  itself.  The  inner  one  is  designated  as  the  jrontal 
notch  or  joramen  (Fig.  65),  wh''  he  outer  one  is  known  as  the  supraorbital  notch  or  joramen* 
(Figs.  66,  68,  and  69). 

The  inner  rir  cerebral  surjace  nf  the  front  1  jxirtion  (Fi«r.  67)  presents  a  median  rifigc  upon 

*  The  supraorl)iial  noKh  is  much  more  fre<|ucntly  [.resent  as  a  foramen  than  the  frontal  notch;  sometimes  b<'th 
of  the  notches  form  a  single  shallow  groove. 


T 


I  he 


I iviildl  ciiiiniiHc 


I'lin'iliil 
honirr 


Frontal  portion 

fiviitdl  Gillian 


Sii/iirr/7i(iry 
iiir/i 


Orbital  portion 

'orhiliil  'iiirfairj  Sii/iriior/'ifii/ 

fcninii  r 


I  i<:.  ()<). 


Sii/ii  n'l'r 
ti/ii/'itni/  litir 

liiiiijonil 
■•iirfiiir 


Nasal  portion  froi,U,l  spin,-  Snpr.iorhiuil  „ot,h 


Siii^itliil  i;ivi}\;- 


I'liriildl 
bordci- 


('nrbnil 

siiifan-  I'f 

In'iitdl 

portiiiii 


:.    Oi. 


(Wr/ini/  siiifiiir  (of  orhmil  pnitioii) 

I ■'•■'■  "!,n  rruhittii 


I  iviiiiil  rirsi 
f  idiilii/  -.pinr 


Mil 


(| 


i 


It 


THE   BONES  OF  THE  SKUI.L. 


6i 


its  lower  portion,  the  jronlal  crest,  which  extends  to  the  joramen  ctrcum  (see  pa^e  41),  and  is 
continued  superiorly  as  a  groo\e,  the  commencement  of  the  sat^iltal  tiromr  (see  page  44).  The 
cerebral  juga,  digitate  impressions,  and  sitki  artcriosi  upon  the  cerebral  surface  of  the  orbital 
portion  are  sometimes  continued  ujwn  the  inner  surface  of  the  vertical  jjlate,  as  there  is  no  dis- 
tinct boundary  between  the  cerebrfil  surfaces  of  the  two  ])ortions  of  the  bone.  The  foramen 
ca;cum  is  sometimes  situated  entirely  within  the  frontal  bone. 

The  two  orbital  plates  of  the  frontal  lx)ne  are  separated  by  a  deep  notch,  the  ethmoidal 
notch  (Fig.  68),  which  articulates  with  the  cribrijorm  plate  of  the  ethmoid  lx)ne.  They  jH)s.sess 
two  surfaces,  a  superior  cerebral  surjace,  which  forms  a  portion  of  the  anterior  cerebral  fos.sa, 
and  an  orbital  surjace,  which  constitutes  a  portion  of  the  nK)f  of  the  orbit.  The  cerebral  .surface 
(Fig.  67)  is  .separated  from  the  ethmoid  bone  by  the  frontoethmoidal  .suture  (Figs.  4.^  and  44), 
and  is  in  contact  with  the  lesser  wing  of  the  s[)henoid  lx)ne  at  the  sphenofrontal  suture.  It 
is  almost  flat  and  exhibits  quite  di.stinct  cerebral  juga  and  digitate  impressions,  as  well  as  the 
sulci  arteriosi  of  the  anterior  and  middle  meningeal  arteries. 

The  orbital  surjace  (Figs.  68  anti  6())  is  distinctly  concave,  and  forms  the  largest  part  of 
the  r(x)f  of  the  orbit  and  also  a  jwrtion  of  its  internal  and  external  walls.  In  this  situation  it 
articulates  (Figs.  37  and  38)  with  the  greater  wing  of  the  sphenoid  Ijone  by  the  sphenofrontal 
suture,  with  the  lamina  papyracea  of  the  ethmoid  Ixjne  b\'  the  fronlcK'thmoidal  suture,  and  with 
the  lachr>i  ,d  Ijone  by  the  frontokulirymal  suture.  The  apjjcarance  of  the  ethmoidal  notch 
as  ^een  from  the  inferior  surface  of  the  frontal  bone  between  the  orbital  surface  is  (|uite  dilTerenl 
from  that  which  it  presents  from  the  cerebral  surface.  It  is  not  limited  by  a  simple  suture,  but 
its  U)rders  are  rather  broad  and  irregular,  and  are  j.roviiled  with  small  depressions,  the  ethmoidal 
del>ressioiis,  which  comjjlete  the  air  c  ills  of  the  ethmoid  bone.  In  the  septa  Ix-twei  n  the  ethmoidal 
cells  there  are  two  gr(K)ves  or  can;d>,  an  anterior  ami  a  jjosterior,  which  run  resjx  <  livelv  to  the' 
anterior  and  posterior  ethmoidal  joramina,  situated  beside  or  in  the  jrontoethmoidat  suture;  they 
give  pa.s.siige  to  the  ves.sils  and  nerves  of  the  same  name. 

The  portion  of  the  orbital  s\  rface  which  is  in  the  inner  wall  i-t  the  orliil  alwavs  presents  a 
•small  (iei)ression,  tlie  trochlear  depression  (Figs.  OS  and  tv)),  and  sometimes  a  small  ix>ny  spicule, 
the  trochlear  spine,  Inyth  of  which  are  m.  named  on  aiiount  of  the  IiI.I'k  artilaginous  |)ulley  of 
the  superior  obli<|ue  musi  le  bi  ing  attached  in  this  situation.  In  the  out.  r  portion  of  the  orbital 
surface  Uneath  the  /ygomalic  process  there  is  situated  a  shallow  depression,  which  lodges  the 
lachrymal  gland. 

The  nasal  portion  of  the  frontal  Inme  il'igs.  <>()  and  67)  i>  the  small  me.han  portion  situated 
between  tlie  ()rl)ii,il  (avities  and  jirojecting  somewhat  below  the  frontal  jHulion.  It  [K)ssesses 
a  very  irregular  roughened  Ixirder,  known  as  tlie  nasal  border,  for  artiiulalion  with  the  na.s;d 
Ixme  and  the  frontal  process  of  the  maxilla,  and  its  inferior  surfati  is  marked  In  a  l)on>  ridge, 
the  jrontal  spine,  which,  together  with  ilf  roagh  nasal  l)order,  articulates  with  the  Ix.nes  which 
fonn  the  skeleton  of  the  nose. 

rile  frontal  Ixme.  like  many  of  the  (ranial  lK)nes,  contains  a  (avitv,  the  jrontal  sinus  (Fig, 
102),  or,  accurately  speaking,  two  cavities,  which  are  sei)arated  by  a  septum  usuallv  jilad'.!  to 
oiif  Mde  of  the  meiiiaii  iinr,  Liki-  the  majority  ol  the  liony  sinuses  lliev  communiiate  with  the 
nasiil  cavity,  the  communication  in  this  instance  Ixing  etTected  by  the  two  ojienings  (Fig.  67) 


-*n;, 


ii 


!    2 


62 


ATLAS   AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 


Fio.  68. — The  frontal  bone  seen  from  IjcIow  (^). 

Flo.  69. — The  frontal  Inme,  the  f;realer  part  of  the  ethmoid,  and  the  nasal  hones  in  place,  seen  from 

below  (i).     The  frontal  bone  is  while,  the  ethmoid  yellow,  and  the  nasal  pink. 
Fir..  70. — The  ethmoid  bone  seen  from  above  ( } ). 
Flc.  71. — The  ethmoid  lM)ne  seen  from  the  side  (}). 
Fic;.  72. — The  ethmoid  Ixme  to^,'ether  with  the  ronrh:e   sphenoidales,  which   are   united  with   it,  .seen 

from  alx)ve  and  jKirtly  from  Ijehind  (j). 


situated  between  the  frontal  si)inc  and  the  ethmoidal  notch.  The  development  of  the  frontal 
sinuses  is  subject  to  j^reat  individual  variation;  they  are  generally  larger  in  advanced  life  than 
during  youth,  and  they  are  always  situated  at  the  base  of  the  frontal  jxirtion,  esj)ecially  behind 
the  su[)crciliar\-  ridges,  the  prominence  of  which  is  actually  dcjjendent  u|M)n  the  size  of  the  sinuses. 
They  frequently  also  extend  into  the  orbital  plates  for  a  varying  distance,  and  are  sometimes 
enormously  developed  and  markedly  distend  the  frontal  lx)ne  in  the  region  of  the  sujx;rciliar\- 
ridges. 

Thi'  frontal  Ntm*  is  <lcvelojK'fi  ontiri-Iy  in  nu'mt)rani.'  from  two  rompictt'Iv  separated  j^ortions.  whieh  prow  from 
two  <enters  of  ossifuation  in  the  frontal  eminenees;  theM'  1  enters,  like  those  of  thi'  parietal  iKine,  apinar  tovvaril  the  end 
of  the  serond  month.  Kven  in  the  new-l>om  the  two  halves  of  the  frontal  l)one  are  eoinpletely  separated  hy  the  frontal 
suture  (FiR.  105),  whieh  diK's  not  ilisiip|H'ar  until  the  serond  year  of  life  and  may  sometimes  1h'  present  in  th<'  ailult.  ami 
is  then  .ilso  termed  the  ineli>/>ii-  suture.  ,\t  .il»mt  the  time  it  dis^ippiars  'in  frontal  :,inu.ses  Upii  m  divelop  anil  tlnA 
enlarge  r]uite  gradually  until  the  time  of  jiutx-rty,  when  thiy  ini  rease  n;   re  rapidly. 


THE  ETHMOID  BONE. 

The  ethmoid  Ixine  (Figs.  70  to  7,^)  forms  the  median  portion  "f  the  nasi!  skeleton;  antl 
its  iribrijorin  fi/iilr  aid.*;  in  the  formation  of  the  lloor  of  the  anterior  cereijnil  fos.sa.  In  the 
artituhiti'd  skull  ihi  largest  ]iorti(U!  of  the  ethmoid  is  (dncealed  by  othtr  Ixmes;  it  is  (|iiite 
centrally  placi-d  and  anidiialis  with  several  of  the  cranial  Ixines  ;inii  with  the  mujorit.  of  the 
f.,iial    Ikhhs. 

It  has,  as  a  whole,  an  irngularK-  tubiial  form,  and  |irrsints  a  median  and  two  lateral  iK)r- 
tions.  Till  fomn  r  tonsisis  nf  a  siiiali  hnri/nMlal  plate,  the  irihrijurni  philc,  and  <if  a  larger 
\ertical  plale,  whiih  (onsisis  of  a  sniail  lliit  kcned  porlinn  situated  alH)\e  the  iribrifomi  plate, 
the  (rislii  f^iilli  ( I'"ig.  711,  and  id'  ,1  larijt  r  ptirlion,  tiie  fx rpi  mlidihir  pliil( .  siuialed  Ulov  ihe 
cribriform  plate,  wliidi  aids  in  the  formation  id'  llir  lK)nv  nas;il  septum  (I'ig.  7,<). 

If  till' median  portion  .'(  thetthnioid  tmne  Ih' o|,s(Tved  fnitii  in  front  or  troin  Uiiittd.  or.  still  U'tter,  in  iross-5M'(- 
lion  ( \\\i  O'Si,  it  "ill  Ix  -"111  to  In'  shaind  like  .1  d.ixxer,  tile  h.indle  of  whii  h  is  formed  hy  the  1  rista  ualli,  the  Ruard  liy 
the  cril'riform  piatr.  .iiid  the  M.ide  In    i!i.    |n  r|H  ndii  ul.ir  |  late. 

.Xltachcnl  to  the  lateral  margins  of  the  lamina  i  ribrosii  are  the  tw.  'ultnil  massts,  .ilso  ti  rmed 
the  illimoiiliil  l.ihyrinllis,  whit  h  art  air-containi  ig  structures  with  thin  lK)ny  walls,  and  form 
a  part  of  the  oiitt  r  walls  of  the  na.sal  foss.e  and  a  part  nf  tin  inner  wall  "f  the  orbit. 

rile  (riMii  i;iiiii  1  Figs.  70,  71,  ami  7;!  is  a  [loiniiMi  ]nm\  ridge  siiuaitd  in  liu  sagittal  jiiane; 
it  is  hioh  in  front  and  low  behinil,  and  gi\ts  attaihiiietii  to  ihe  fal\  (enbri.  The  crihrijorm 
plait  I  Figs,  (m),  70,  and  7^1  is  an  approximately  rectangul.ir  plati'  siliiatetj  Ulwitii  the  cranial 


«L-^.: 


I roili'mr  spiin 
Sii/ieni/idiy  iirch 


I lontiil  s/iiiir     (ilahilld 


I ivrlilrnr  ili;tii''< </ciii 


Sifininrhiliil  iiuuxin 


il  siir/iKV  of 
hitiil  /lortiint 


/[■i^i'iiiiitir 


Anterior  (niii.oiaal  loraniiii  ,   , 

I'oslmor  fthmoiitdl  foivmcn  iiolifi    I'limotdiil  ,/r/iirs^ioiis 


/7".  (kS. 


Ill 


Siipidorliitdl  iioliii 


Drpnssioii  for  .-'' 

IdchrvnidI  daiiil       / 


/yi;o/ihitii'  /iroi'i'is 


Mur  /imrc^s  firrn:- 

1  <timtnr 

Cli^td  f;d//i  i  f'I'di 


tii^.   70. 


Ii<'.  ()'). 


(  rihrjorin  pldtf      I'ir/iriidini/dr  /i/dir  of  itlrnoiil  hone 

(  n\lit 

I  iiiiiino  ;id/i,'rdiiii 


A/iii  /irortw 


11/,/,//, 

I  ihmoiiidi        ■  ',^  "'t'.',',;""' 

'■'//         Per  pen-         I  middle 

'"pi'JtV     '""""    '""""■' 


f'k'-  '"■/. 


V       ■■<'llld/  \ldlls 


Hk'    72. 


\'hi  iii'iilii! 
liirhiiitiliil  hoiii 


I     f 


i 


it^ 


mmaam 


.'~Mkdt 


THE  BONES   OF  THE  SKULL. 


63 


and  nasal  cavities,  and  it  con  .cnt'i  forms  a  portior  the  roof  of  the  nasr.l  fossas.  It  jios- 
scsses  a  number  of  irre<?uL.  rounde^l  foramina,  thn  .;h  which  ])as.s  the  olfactor>-  nerves 
from  the  olfacton,'  bulb,  which  -csts  upon  the  cribriform  j)late;  the  nerves  for  the  most  i)arl 
continue  their  course  downward  in  small  lx)ny  gr(M)ves  ui)on  the  nasid  septum  and  the 
lateral  nasal  wall.  The  most  anterior  foramen,  frequently  incomplete,  ^ives  passa>,n  to  the 
anterior  ethmoidal  vessels  and  nerve.  In  front  of  the  crista  p;alli,  the  cribriform  i)late  sends  out 
two  small,  somewhat  (|uadrangular,  Ijony  platelets,  the  ahir  processes  (Fij.^.  70),  which  pass 
toward  the  base  of  the  frontal  crest  of  the  frontal  bonj  and  usually  complete  the  foramen  ciecum 
posteriorly  (Figs.  43  and  44).  The  cribrifonn  plate  is  situated  in  die  ethmoidal  notch  of  the 
frontal  bone  and  articulates  posteriorly  with  the  ethmoidal  spine  of  the  sphenoid  Iwne. 

The  perpendicular  plate  (Figs.  69  and  73)  extends  downward  in  the  spacv  lx>twcen  the 
two  lateral  massis  and  forms  the  anterior  superior  portion  of  the  bony  nasal  septum.  It  is 
approximatelv  pentagoi.  d  in  shape.  Its  anterior  superior  border  articulates  with  the  frontal 
spine  by  the  frontoethmoi'hl  suture;  its  anterior  infericr  lx)rder  is  continuous  with  the 
cartilaginous  nasal  septum*;  its  inferior  border  ardculates  with  the  superior  ix)rdef  of  the 
vomer,  which  forms  the  remainder  of  the  tony  septum;  its  jwsterior  lior  ier  articulates  with 
the  si)hen<Mdal  crest  of  the  Ixxiy  vi  the  sphenoid  bone  by  the  sphenoethmoidal  suture;  and  it,- 
supc.-ior  Ixjrdcr  is  received  bet  .vccn  tvo  ridges  upon  the  inferior  surface  of  the  rrihriforni  ])late. 

The  ethmoidal  lahyririns  or  lateral  masses  are  ])aired  stnictures.  Their  cavities  are  more 
or  less  comi)letely  subdivided  by  numerous  fine  ix>ny  ])latelets  into  the  ethmoidal  cells,  which  arc 
onlv  j)artially  situiited  within  the  ethmoic'  Ixme  and  are  frequently  cl(xsed  in  by  neig  'ng 
tones,   particularly   by   the   frontal. 

\Vc  may  ionsii|iicnllv  (li>iinKuisli  th.-  rthmoidal  alls  pnijxT.  i  r.,  th<is>-  nhirh  ,iri  actually  inil..s»'(l  within  tin- 
I'lhmoid  Ixinc  hv  the  I,  inina  papyraroa,  from  thoM-  whii  li  an-  ilosiil  in  liy  the  Inints  adjaunt  I.)  ilu-  cilin-'ii!  ( :lii-  Innlal, 
la>hr\-nial,  sphomiidil,  maxillary,  and  palatini-  ivWs). 

The  external  surface  of  the  labyrintli  finTns  a  jmrtion  of  the  inner  wall  of  the  or!;it  (Figs, 
o;  and  qO).  It  is  (juadriLteral  in  form,  and,  on  aitount  of  its  iMreiiu  thir.  less,  is  known  as 
the  /.  .('«(/  papyraeea  (Fig.  70),  al'hough  it  is  also  known  as  \\\r  's  planum.  In  the  nrbital 
cavi'v  it  articulates  anteriorly  with  the  lachrymal  Ixme,  inferioriy  witli  tlif  niaxill.i,  ])osteri()rlv 
with  tile  palate  Ixme  (the  orbital  surface)  and  superiorly  with  tile  r  l>itai  plate  of  the  Ironlal  l)(me,t 
the  two  (thmoidal  joramiiui  (see  jiage  ()i  )  king  siiuated  either  ch.  ,i  to  (-r  ac  tually  m  iht  froiito 
ethmoidal  sv.ture  (Figs,  ijs  and  06V  The  margins  of  the  adjacent  iM.nes  .lici  more  or  less  in 
ilcsing   in   thr   .llimoidal   eel',-. 

The  internal  wall  of  the  echmoiik  I  labvrinth  (Figs.  101  awl  ioj>  forms  the  ujiper  i«)rti<in 
(It  the  tnitc!  nasiil  wall,  and  from  it  two  lliin  rough  Umv  platis,  v.Ikkc  free  margins  are  sliu'htlv 
rolled  up,  ()roject  into  the  nasal  fossa;  iliese  ale  tlu-  short  ^u prior  and  tin  longer  middle 
turbinitled  bone  (<  'lue  iiasales  suptrior  ,t  media).  The  , interior  extremity  of  thr  middle 
turbinated  tone  a,.iculates  with  the  ethmoidal  crest  of  the  rroiital  prints-,  of  the  mavilla,  wiiile 


lr!l 


*  In  tliissilualiun  llir  piTp.ndii  ul.ir  plati- i- usually  (jnov.-il  |..r  ili.  .111  1.  limi  lU  <if  tlu  1  artilam- ^f  Ihr  imwiI  vcpmn 
it  is  rari'ly  placed  r.iartly  in  the  mi-dian  lini-  liul  usu.dlv  d<u,it<-i  to  one  -id< 

t  These  suturrs  have  been  pn-vinusly  noieil  and  tluy  «ill  tie  lonsidered  in  detail  u|"in  paRi   7<(. 


II 


64 


ATLAS    AND   TEXT-BOOK    OF   HUMAN   ANATO>ry. 


H     f 


its  posterior  extremity  is  attached  to  the  similarly  named  crest  of  the  palate  bone.  Between 
the  sui)erior  and  middle  turbinated  bones  is  situated  the  superior  meatus  ot  i  ic  nose,  whicK  is 
short  and  developed  only  in  the  j)osterior  portion  of  the  nasal  fossa-.  Between  the  middle  and 
inferior  turbinated  bones  (the  latter  structure  iK'ing  an  independent  bone)  is  the  middle  meatus, 
in  which,  covered  by  the  middle  turbinated  bone,  there  is  a  bulging  of  the  ethmoidal  wall,  the 
ethmoidal  bulla,  a  rudimentar>-  turbinated  bone,  and  another  rudimentary  turbinal  (the  osnaso- 
turbinale  of  the  mammalia)  is  the  sickk-shaped  uncinate  process  (Figs.  8i  and  102),  which  is  also 
covered  bv  the  middle  turbinated  bone.  It  articulates  with  a  j)rocess  of  thi  inferior  turbinated 
bone  (see  below)  and  helps  to  close  the  orillce  of  the  maxillarv'  sinus.  Between  the  uncinate 
process  and  the  etlimo-lal  bulla  is  a  wide  fissure,  the  injundibulum,  which  leads  both  into  the 
orifice  of  the  frontal  sinus  and  into  the  ethmoidal  cells;  its  orifice  in  tne  nasal  fossa  is  known  as 
ihc  hiatus  semilunaris  (Fig.  loi). 

The  ethmoidal  cells  communicate  partly  with  one  another,  partly  with  the  air-cells  of  the 
adjacent  bones,  and  in  all  cases,  either  directly  or  indirectly,  with  the  nasal  fossae. 

The  ethmi)i(l  txme  is  cnmplrti-ly  |>rrfn\-mc(i  in  cartilagi-.  Ossification  commi-nccs  late  (in  the  fifth  month  of  cm- 
Ijrvonic  life)  and  pr<x  icds  from  the  lamina  papyraiea  and  the  middle  turhinated  Ixme.  In  the  new-lxJin.  the  two  lal)v- 
rinths  h.ive  air.  ady  ossified  as  far  as  thi'  superior  lurtiinateil  Ixme,  hut  thiy  are  n  .  connected,  since  the  crihriforni  and 
[HTix-ndirular  plates  do  not  possi-ss  ossitu  centers  unti  the  first  year  of  Ufe,  when  they  gradually  elTect  a  bony  union  of 
the  two  labyrinths.     Tlie  remainder  of  th;-  perjiendicular  p.aK'  does  not  ossify  until  the  fifth  year. 

THE  INFERIOR  TURBINATED  BONE. 

While  the  two  upf)er  turbinated  bodies  arc  portions  of  the  ethmoid  Iwnc,  the  inferior  one 
(concha  nasalis  injerior)  (Figs.  ;(),  81,  82,  and  ()8)  is  an  indejiendent  structure  and  it  is  also  the 
largest  of  the  three.  It  is  a  thin  roughened  lK)ny  plate,  the  free  margin  of  which  is  turned  upon 
itself  and  slightly  rolled  up.     It  consi>ts  of  a  b<Kly  and  of  three  jirocesses. 

The  narrow,  leaf-shaped  body  is  placed  in  the  sagittal  ])lane.  It  is  convex  towanl  the  nas;U 
sejituni,  concave  toward  the  lateral  nasal  wall,  broader  in  front  than  behind,  and  isjirovided  with 
manv  depressions  and  small  foramina.  The  anterior  portion  of  the  lateral  Ijorder  articulates 
with  the  conchal  crest  of  the  maxilla  (Figs.  81,  101,  and  102),  and  the  posterior  jwrtion  of  this 
Ixirfler  is  attached  to  the  similarly  named  crest  of  the  jialate  Ijone. 

The  largest  of  the  three  processes  is  the  maxillary  process  (Fig.  82),  which  is  directed  down- 
ward tnd  outward,  and  closes  a  considerable  portion  of  the  orifice  of  llie  niaxillar}-  sinus  (see  Hg. 
101 1.  The  lachrymal  process  (Figs.  61  and  821,  passing  forward  and  upward,  articulates  with 
the  lower  lK)rder  of  the  lachr>nial  Inme  by  the  lachrymocont hal  suture,  and  forms  a  jiortion  of 
the  wall  of  the  nasal  duct  (nasolachrymal  canal)  (Fig.  ;()).  Thv  ethmoidal  process  (Figs.  81,82, 
and  102)  is  directed  ujiw,!-  nd  backward  and  artictilates  with  the  uncinate  jirocess  of  the 
ethmoid  Ixme  in  the  regio         the  orifice  of  the  maxillary  sinus. 

The  inferior  liirliitialed  1.  .n.  ussjfi.s  in  immediate  connection  with  the  ethmoid  Ixmi-  in  tin-  fifth  month  of  em- 
bryonic lifi . 

THE  LACHRYMAL  BONE. 

The  lachrymal  hone  (Fig.  781  is  an  approximateh'  rectangtilar  bony  plate,  ven-  thin  and 
frequently  even  perforated,  situated  in  the  inner  wall  of  the  orbit  between  the  frontal  jirocess  of 


THE   BONES   OF   THE  SKULL. 


f>> 


the  maxilla  and  the  lamina  papyracea  of  the  ethmoid  bone  (Fips.  95  and  96).  It  articulates 
with  the  nasal  portion  of  the  frontal  bone  above,  with  the  inferior  turbinated  l)one  bel  v,  and 
extends  inward  as  far  as  the  nasal  fossa  (the  sutures  are  considered  ujjon  papie  79). 

It  presents  an  external  or  orbital  surjace,  and  an  internal  or  rtlvnoidal  surjaic,  which  is  in 
contact  with  the  ethi-'ioid  bone.  The  ethmoidal  surface  closes  in  the  laihrymal  tells,  and  a 
sniall  {x>rtion  of  it  aids  in  the  formation  of  the  outer  nas;d  wall  in  the  middle  meatus,  as  it 
articulates  w'th  the  lachrvjnal  process  of  the  inferior  turbinated  lx)ne  by  the  lachnimoconchal 
suture  (Fig.  loi). 

The  anterior  ]K)rtion  of  the  orbital  surface  exhii)its  a  widi  groove  which,  together  with  a 
similar  groove  on  the  frontal  ])roc  'ss  of  the  maxilla,  forms  a  dejjression  for  the  lachr}mal  siic 
(see  Fig.  77).  The  jx>sterior  bouni.an,'  of  this  ile])ression  is  the  poslrrior  lachrymal  crest  which 
extends  downward  into  a  hooic  like  irocess  (bent  up  anteriorly),  the  hamulus  lacrimalis  (Fig. 
78).  This  is  situated  in  Jie  lachrymai  notch  IxHween  the  frontal  process  of  the  maxilla  and  the 
orbital  surface  of  the  Ixxly  of  the  same  Ijone  (see  page  67).  The  posterior  jwrtion  of  the  orbitai 
surface,  situated  Ix'hind  the  lachninal  crest,  is  smooth. 

[The  laihrymal  liono  is  formni  I'v  ossifiiation  iif  mcmlirano  and  usually  develops  from  a  single  cirUir  whii  h  a|i|Hars 
during  tli'  liird  or  fourth  month  of  fetal  lifr.  ( )i  i  asion.'lly  tworcnIiTs  apj.rar,  from  onr  of  \vhi(  h  the  harv.ulus  ili'vrlo(is, 
and  moR-  rarely  a  number  of  centers  cki  ur,  in  whii  li  ease  the  Ixme  is  represented  hy  a  numlxr  of  se|ii  Mle  parts — Ku] 

THE  NASAL  EONE. 

The  nasal  bones  (Figs.  86  and  87)  are  two  Hat,  elongated,  tr:ij)ezoidal  Ixines,  which  meet 
in  the  median  line  to  form  the  bridge  of  the  nose  (Figs.  ^7  and  ,v*^'-  The  interna al  suture 
separates  the  short  internal  margins  of  the  i  -o  Ixmes,  while  the  external  margin  of  each,  consit'er- 
ably  longer,  articulates  with  the  front;.'  oeess  of  the  maxilla  b\  vhe  nasi)ma\illar\-  suture. 
The  shorter  and  thicker  sujjerior  margin  is  in  contact  v'th  the  nasal  |.orti  )n  of  the  frontal  ]x)ne 
by  the  nasofrontal  suture;  the  longer  and  thinner  inferior  margin  forms  ihe  upper  ljoun<lar\- 
of  the  anterior  nares  (aperlura  pirijormis)  and  give^  allachjnent  to  the  cartilaginous  nasal 
skeleton. 

The  slightly  conca\e  inner  (nasal)  surface  of  each  Inme  ])rL'sents  a  groove,  the  ethmoidc! 
grooi'f  (Fig.  87),  for  the  anterior  ethmoidal  ner\e,  and  in  tiie  neighljorlKKxj  of  this  are  one  or 
more  line  foramina,  the  nasal  joraniina,  leading  to  the  slightly  iimvex  external  surfaic  of  the 
Ixine.     Roth  the  sui)erior  and  inferior  margins  of  the  lx)ni-  are  usualiv  irregidarlv  serrated. 

[I-,a(  h  nasiil  lx)n<'  is  <leveloped  from  a  -.inKle  center  i>f  ox-.ili.  alion  whic  h  appears  in  r.enibrane  at  atxml  the  third 
month  of  fetal  life.     At  birth  the  length  of  the  Umes  hardly  excwds  their  breadth. —  Si)  ] 


i    IH' 


THE  VOMER. 

The  vomer  (Figs.  73  to  75)  of  the  adult  skull  is  a  tlat  single  Ixine,  approximately  trapezoid 
in  shape,  which  fonns  the  inferior  and  (Xjsterlor  )K)rtion  of  the  lx)nv  nasal  seittum  (Fig.  7^1. 
its  upper  end  is  thickened  and  spread  out  into  two  plat's,  the  ahr  (Fig.  741,  which  articulate 
with  the  inferior  surface  of  the  Ixxly  of  the  s])henoid  Ixjnc  in  such  a  manner  that  the  sphenoi(kil 
rostrum  is  received  between  them,  while  the  vaginal  i)rotes.ses  of  the  pterygoid  prcness  and 
5 


66 


ATLAS    AND   TEXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  yj.—The  osseous  nasal  septum  seen  from  the  left  side.  The  frontal,  sphenoid,  maxilla,  and  palate 
bones,  and  al^o  the  lamina  cribro!  a  of  the  ethmoid  and  the  ala  vomeris,  have  been  sawed 
throuf^h  close  to  the  median  line.  The  ethmoid  is  yellow,  the  vomer  (e.xcept  the  cut  sur- 
face of  the  ala)  pink. 

Fig.  74.— The  vomer  seen  from  behind  (\). 

Fig.  75.— The  vomer  seen  from  the  side  (}). 

Fig.  76.— -The  right  maxilla  seen  from  the  inner  surface  (\). 

Fig.  77.— The  right  ma.xilla  seen  from  the  outer  surface  (}). 


the  sphenoidal  process  of  the  jialate  bone  (see  page  70)  arc  applied  to  their  margins. 
The  pxjstcrior  border  of  the  vomer  forms  the  septum  choanarum;  the  narrow  anterior  border 
articulates  with  the  cartilaginous  septum  of  the  nose  and  the  anterior  portion  of  the  nasal  crest 
of  the  maxilla;  the  superior  lx)rder  is  attached  to  the  peq)endicular  plate  of  the  ethmoid;  and 
the  inferior  one  is  firmly  fixed  to  the  nasal  crests  of  the  maxilla  and  palate  bone  (Fig.  73). 

The  vomer  arises  during  the  third  month  of  fetal  life  as  two  plates  situated  one  on  either  side  of  the  upper  part  of 
the  cartilaginous  septum  of  the  nose,  which  subsequently  disappears,  so  that  the  two  plates  become  adherent  after 
birth,  with  the  exception  of  the  ala-,  which  remain  separated  throughout  life. 


THE  MAXILLA. 

The  maxilla  (Figs.  76,  77,  a.id  79)  is  a  paired  lx)ne  which  forms  the  center  of  the  facial 
skeleton,  all  portions  of  which  arc  more  or  less  intimately  connected  with  it.  It  assists  in  the 
formation  of  the  orbit  and  forms  a  considerable  portion  of  the  nasal  fossx  and  of  the  roof  of  the 
mouth. 

It  consists  of  a  bmly  and  of  four  processes,  the  jrontal  or  nasal  process,  the  zy_qomatic  process, 
the  palatine  process,  and  the  alveolar  process.  Of  these,  the  aheolar  process  is  directed  downward 
and  the  frontal  process  upward,  while  the  zygomatic  and  palate  ])nKesses  extend  in  the  hori- 
zontal plane,  the  former  externally,  the  latter  internally. 

The  body  of  the  maxilla  is  irregularly  cubical,  and  contains  a  large  cavity,  tht.  maxillary 
sinus  (Figs.  70,  79,  97,  and  ()&},  also  known  as  the  antrum  oj  Highmore.  In  the  body  there  may 
be  recognized  four  surfaces:  the  anterior,  the  nasal,  the  orbital,  and  the  injratemporal. 

The  actual  facial  surface  of  the  bone,  the  anterior  surjace  (Fig.  77),  is  convex,  and  i'- 
sui)erior  loonier  forms  a  ])ortion  of  the  infraorbital  margin.  Helow  this  margin  is  an  irregula. 
rounded  opening,  the  injraorhital  joramen  (Figs.  ,^7,  .^jS,  and  77),  which  gi\es  exit  to  the  vessels 
and  nerves  of  the  siime  name  and  is  the  termination  of  the  infraorbital  canal.  Below  the  infra- 
orbital foramen  there  is  a  (lei)ression,  the  canin(  jo'isa,  which  gives  origin  to  the  musculus  caninus 
(levator  anguli  oris).  The  anterior  Ixirder  of  the  facial  surface  forms  a  portion  of  the  lateral 
l)<)undarv  of  the  apertura  pirijnrmis  (anterior  naresi.and  at  the  infraorbital  margin  the  surface 
becomes  continuous  with  the  triangular  orbital  surjace,  which  articulates  with  the  lachrymal, 
zvL^omatic,  and  ethmoid  Ixmes.  but  is  se[)arate<l  from  the  greater  wing  of  the  .s])henoid  by  the 
inferior  orbital  (.sphenomaxillary)  fissure  (Figs.  95,  96,  and  97).  This  is  a  smooth  surface; 
it  assists  in  forming  the  tloor  of  the  orbit,  and  exhibits  a  gradually  deepening  groove,  the  injra- 
orbital  firo(n\'  (Fig.  9O),  along  which  there  is  fre<iuently  to  be  observed  an  infraorbital  suture. 


Crista  gal/i 


Cribriform  plate  of  ethmoid 


Frontal  sinas 
Nasofrontal  suture 

Nasal  bone 


Perpendicular 
plate 

f-'rontal  process  of  maxilla 


Vertiral  portion  of 
frontal  hone 

Sphenoidal  rostrum 
Sphenoidal  sinus 

(liody  of  sphenoid  Iwne) 


(iltie  vomeris 


Ethmoi- 
dal ■ 
cres 


Fig.  73. 

Ineisive  canal 

Vomer 

t'rontamaxillary  suture 

Frontal  process 


.Ma  vomeris 
I'teryooid  process 

Posterior  nasal  spine 


I'ah, 'ine p-oerss    Palate  bone  (horizontal portion) 
of  maxilla 


Fig.  74. 


.-^■^^K. 

,!/(((■  vomeris 

J^ 

^ 

Maxiilarv  sinus 

Septum 
ehoihiarum 

I'terynopuhiline  (;roov 
Palate  process 


I  iiehryinal  border 

tmhivnuil  rh>tt/l 

/'ni, 
fill  Mil  fat 


luherosity     „,.,,„,,/  ^      lnfn„;l„t„l m,,,^,, 

of  maxilla 
Infraorbital  t;i\ •0V( 


Frontal  process 

(anterior 
al 


Ineisivi  canal  f^jcr,   7(j. 


Infratemporal . .  <|  fe' 
surface      \>^\ 

.\lveolar  foi amino 


Zygomatic  process     j     'j*'. 


'  ^ 


"^^■^m 


THE    BONES   OF   THE   "KUI.L. 


67 


The  infraorbital  groove  pratlually  leads  into  a  canal,  the  injraorhilal  canal,  whirh  runs  to  the 
infraorbital  joramen.  The  inner  margin  of  the  ortiital  surface  presents  a  notch,  the  lachrymal 
notch  (Fig.  77),  which  accommodates  the  hamulus  of  the  lachrjmal  Ixme. 

The  infratemporal  surface  (Fig.  77)  is  situated  Ix'hind  the  zygomatic  process,  toward  the 
infratemporal  and  sphenomaxillar>'  fossie,  and  represents  the  j)Osterior  surface  of  the  Ixxlv  of 
the  ma.xilla.  It  bulges  somewhat  posteriorly,  forming  the  tuberosity,  and  jiresents  a  pteryf^ofx- 
tine  grome  (see  page  79),  and  also  from  two  to  four  small  foramina,  know,  us  the  alveolar  i,..a- 
mina,*  which  transmit  the  nerves  and  vessels  of  the  sami  name.  The  superior  internal  angle 
articulates  with  the  orbital  process  of  the  palate  bone. 

The  nasal  surface  (Fig.  76)  forms  the  lower  portion  of  the  outer  wall  of  the  na.sid  fossa; 
it  exhibits  a  large  irregular  opening,  the  ori/ice  of  the  maxillary  sinus,  .^bove  this  orifice  there 
are  usually  fossa  and  depressions  which  close  in  the  incomplete  maxillary  cells  of  the  ethmoid 
bone.  Only  a  small  part  of  the  anterior  jjortion  of  the  na-al  surface  is  ex])osed  in  the  lateral 
nasal  wall,  the  entire  roughened  posterior  jwrtion  of  this  surface  tx^ing  concealed  by  other  Ixjnes, 
namely  the  palate  bone,  the  inferior  turbinated  bone,  and  the  Mncinate  process  of  the  ethmoid 
(Fig.  81),  which  considerably  diminish  the  size  of  the  orifice  of  the  maxillan,-  sinus  (see  also 
page  69).  Refeen  the  orifice  of  the  sinus  and  the  frontal  process  there  is  a  deep  gr(X)ve,  the 
lachr  lal  grooin  iFig.  i)o),  which  is  converted  into  the  nasolachrymal  canal  by  the  lachrvmal 
bone  and  the  lachrymal  i)rocess  of  the  inferior  turiMnated  Ixine  (see  page  64).  The  transition 
of  the  nasal  surface  to  the  frontal  pnKcss  is  indicated  by  a  rough  ridge,  the  comlial  crest  (Fi". 
76),  for  the  attachment  of  the  anterior  portion  of  the  inferior  turbinated  lx)ne  {concha  msalis 
inferior)  (see  also  page  64). 

The  upper  extremity  of  the  frontal  process  articulates  with  the  nas;il  jiortion  of  the  frontal 
bone  by  the  frontomaxillar)-  .suture;  its  inner  margin  is  in  contact  witli  the  na.s;d  txme  bv  the 
nasomaxillary  suture,  and  its  outer  or  lachrymal  border  is  oj)ix)sed  to  the  lachrj'mal  Ixjne  along 
the  lachrymomaxillan.-  suture  (Figs.  ,^7  and  38).  It  narrows  as  it  passes  upward  and  presents 
an  external  surface,  forming  the  lateral  portion  of  the  lx)ny  nose,  and  an  internal  surface,  directed 
toward  the  na.sal  cavity.  This  internal  surface  is  seppr'ted  from  the  nas;d  surface  of  the  Ixxly 
of  the  lx)ne  by  the  conchal  crest,  and  parallel  to  t'  are  is  a  less  ])rominent  ridge,  the 

ethmoidal  crest,  for  articulation  with  the  anterior  pi  .   the  middle  concha  of  tlie  ethmoid 

bone. 

The  external  surface  of  the  frontal  process  presents  the  lachrymal  f^rooir,  which,  together 
with  the  .similarly  named  gnxjve  of  the  adjacent  lachrymal  bone,  forms  a  :  iressinn  for  the 
accommodation  of  the  lachrymal  sac.  The  sharj)  anterior  Ixirder  of  this  tossa  is  called  the 
anterior  lachrymal  crest  (Figs.  77  and  qs).  The  frontal  ])rocess  also  forms  tlie  largest  i)art  of 
the  lateral  lx)unflar>-  of  the  apertura  piriformis. 

The  zygomatic  process  (Fig.  77)  is  broad,  short,  and  three-sided,  and  terminates  in  a  rough 
articular  surface  for  the  Ixxly  of  the  zygomatic  lx)ne  (zygomaticomaxillary  suture).  The  maxil- 
lar)-  sinus  extends  into  the  ba.se  of  the  jjrocess. 

*  These  lca<l  into  small  c  anals,  thi-  nlveoliir  cinnls.  \vhi<h  '.ontain  the  nerves  and  ves-sels  fur  the  molar  teeth  anil 
terminate  in  the  posterior  alveoli,  while  the  alveolar  (anals  for  the  c  anine  and  incisor  teeth  i)roteed  from  the  fl<K)r  of  the 
infraorbital  canal  and  run  within  the  thin  anterior  wall    if  the  bfxiv  of  the  maxilla. 


M 


68 


ATLAS    AND   TEXT-BOOK   OF    HUMAN    ANATOM\'. 


Flc.  78. — The  left  lachry  -ul  hone  seen  from  its  median  surface  (i). 

Fn..  7g. — The  lower  half  of  the  facial  portion  of  the  skull  which  has  been  divided  horizontally,  seen 

from    above  (|). 
Fir..  80. — The  rifiht  maxilla  and  palate  lx)ne,  seen  from  the  inner  surface  ({). 
F'lo.  81. — The  rifiht  maxilla,  palate  bone,  inferior  turbinated  bone  and  part  of  the  ethmoid,  seen  from  the 

inner  surface  (\). 
Fig.  82. — The  inferior  turbinated  bone  seen  from  its  lateral  surface  ({). 

In  Figs.   79  and  81  the  maxilla  is  coloral  yellow,  thi-  sphenoid  green,  the  palate  lK)ne  blue,  and  the  ethmoid 
orange. 


1       I 


I 


The  zygomatic  pn«  es.s  fornix;  the  lower  portion  of  the  outer  iii.irgin  of  the  inferior  orbital  (sphenoma.xillary)  fis.sure, 
and  is  eonlinued  as  a  Hal  proie»,  the  orbital  plale,  ujxm  the  orbital  surface  of  the  IkkIv  of  the  Ixme  in  su(  h  a  manner 
that  it  forms  the  floor  of  the  original  infraorbital  gnxive.  In  young  .subjeets  thi;  orbital  plate  is  always  separated  from 
the  other  Ixjnes  by  the  iiilrnorhilal  suture,  whieh  is  also  frerjuentiy  observable  in  the  adult  skull. 

I  he  alveolar  process  i.s  convex  externally,  concave  internally,  and  contains  eight  of  the  si.x- 
tecn  u])]XT  teeth.  It  is  directly  continuous  with  the  lower  surface  of  the  Ixxly  of  the  lx)ne,  is  .sepa- 
rated from  the  frontal  jjrocess  by  the  )iasal  notch  (Fi<r.  77),  and  forms  the  inferior  and  a  jwrtion 
of  the  lateral  boundar)'  of  the  apcrtura  piriformis.  Both  alveolar  processes  arc  in  contact  in  the 
median  line  in  the  intcrmaxillarv-  suture,  and  their  superior  margins  form  the  anterior  extremity 
of  the  nasal  crest  and  the  anterior  nasal  spine.  The  free  inferior  margin  of  the  process,  the 
limbus  alveolaris,  contains  the  sockets  (alveoli)  for  the  roots  of  the  teeth,  and  these  are  sei)arated 
from  each  other  by  the  interalveolar  septa.  The  r(K)ts  of  the  front  teeth  particularly  cause  the 
walls  of  the  alveoli  to  jjroject  externally  and  in  this  manner  produce  the  juga  alveolaria  (Fig.  77). 

The  apices  of  the  posterior  alveoli  are  situated  immediately  beneath  the  maxillan,'  .sinus 
and  are  separated  from  it  only  by  thin  layers  of  Ixjne  (Fig.  98),  and  at  the  summit  of  even,-  alveolus 
is  the  orifice  of  an  aheolar  canal  (see  page  67).  Posteriorly  the  alveolar  jjrocess  is  directly 
continuous  with  the  tuljcrosity,  anteriorly  with  the  palatine  process. 

The  palatine  processes  ( F"igs.  7()an(l  loolof  the  two  maxilhe  articulate  in  the  median  line 
in  the  anterior  ])ortion  of  the  middle  palatine  suture  (Figs.  41  and  42)  and  form  the  largest  portion 
of  the  hard  ])alate.  Each  presents  a  sli;,',tly  concave,  relatively  smcxith  nasiil  surface,  which 
forms  the  floor  of  the  nasal  fos.s;!,  and  a  markedly  concave,  extremely  rough  palatine  surface, 
which  is  directly  continuous  externally  with  the  alveolar  process.  In  the  median  line  Lmmcdiatcly 
behind  the  junction  of  the  two  alveolar  i)nKxs.ses  each  palatine  process  exhibits  ujx)n  its  j)alatine 
surface  an  incisive  notch,  and  the  corres])on(ling  notches  of  the  two  lx)nes  form  the  inferior 
o|)ening  of  the  incisive  foramen  (F'ig.  100),  which  has  two  orifices  into  the  nas;il  fos.s;e,  one  on 
either  .side  of  the  bony  nasal  septum  (Fig.  78).  The  jialatine  surface  (Fig.  loo)  also  jwssesses 
rough  longitudinal  ridges  and  gnxnes,  the  palatine  spines  and  f^rom'es,  the  latter  accommodating 
the  ve.s.sels  and  nerves  of  the  hard  palate. 

Ujwn  the  nasal  surface  of  the  palatine  proccs.ses  the  thickene-t!  and  roiled  uj)  margins  of 
the  two  Ixines  unite  in  the  median  suture  to  form  the  nasal  crest  (Fig.  70),  into  which  is  inserted 
the  inferior  margin  of  the  vomer.  To  either  side  of  the  anterior  extremity  of  this  crest  is  situated 
one  01  the  nasal  orifices  of  the  incisive  canal. 


/niitsviTsr  /iii/iitiiir  siiinir 
Inf.  ptcryf^oid  /'trnxcid  piViYss 

Ext.  pter)'frnid  plate      plale 


Depression  for 
lachrymal  sue 


Hamulus  lacrimalis 

Fig.  78. 


Posterior 

lachrymal 

crest 


Nasolachrymal 
canal 


Inci.'^'vr  foramen        Na'ial         ,\pertiira  /lin/ormis 
crest 


.'1^'"'''?"  r.thmoidal  cnst 
^.%,^ff    """      of  pah't,  hone  ^  i  ,  ,■ 

ijir    I  i^rooYe      ■  i^plienopalattne 


t'i''    70. 


notch 


I  iieinatr 
t/iroct'ss  of  illimoid  hone 


I  tithnrital    *         ^^, 

nasal  /„„„. 


Fig.  80. 


r.thmoidal  process 


.1,'     'llary  /iroeess 


l-inliryaud  process 


I  i/iin,<i,/,i/ 
i<f   inhr. 


m 


>'■'.    '■ 


{ 


//>.  82. 


l-i<'.  SI. 


m- 


m    : 


THE  BONES  OF  THE  SKULL. 


69 


In  the  skull  of  the  new-born  and  of  the  child  the  hard  palate  always  shows  an  incisive 
suture,  which  is  also  frequently  observed  even  in  adult  life  (Fig.  100). 

In  thi-  fetus  \iolh  {hv  im  isor  lei-lh  and  thiir  alvioli  arc  situatiil  in  a  special  Ininc,  thi'  inlrrmaxillary  hove  or  iw  inci- 
sk'tim,  whiih  also  forms  ihc  anlcrior  jMirtion  of  the  hard  palate.  Although  the  portion  of  the  incisive  suture  inditating 
the  Uiundary  iH-twcen  ihi'  intermaxillary  Ixine  and  the  alveolar  piotess  usua..y  ilisappears  liefore  hirtli,  the  iiKisi\e  suture 
upon  the  hard  palate  is  maintained  for  a  eonsiderably  longer  time. 

The  upper  jaw  is  formed  in  membrane  towanl  the  end  of  the  sei  ond  fetal  month,  from  four  or  five  ( enters  of  ossi- 
fication, two  of  which  form  the  intermaxillary  l)one  and  remain  independent  longer  than  the  others,  whiv  h  usuallv  unite 
as  early  as  the  fourth  month  of  fetal  life.  The  infraorbital  suture  is  another  indication  of  the  <omple\  origin  of  the 
maxilla.  The  upper  jaw  of  the  new-lxirn  is  considerably  flatter  than  the  fully  developed  bone,  and  ihi-  alveolar 
process  is  entirely  wanting,  lirst  a|i|iearing  with  the  ilevelopment  of  the  teeth  and  not  Ixing  lompletely  formed  until  a 
considerably  later  periml.     The  up]»er  jaw  contains  a  maxillary  sinus  even  during  fetal  life. 


THE  PALATE  BONE. 

The  palalc  bone  (Figs.  8:5  to  851  is  a  llat  ])aited  lK)ne,  very  thin  in  certain  places,  wliich  is 
ap])lied  to  the  posterior  ]>ortinn  of  the  maxilla  and  also  articulates  with  tile  splienoid  (body 
and  pterygoid  processes)  and  with  the  inferior  turi)inated  Ijones.  It  consists  of  two  rectaiioular 
txiny  l)lates  placed  at  right  angles  ti>  each  other,  one,  the  Itnrizonlal  pUile,  being  in  the  hori/onlai, 
and  the  other,  the  perpendicular  plate,  in  tile  sagittal  plane.  The  palate  ixme  also  posses.ses 
three  ])r')cesses. 

The  Iwrizuntal  plates  of  the  two  p.ilate  Ixmes  form  the  ]iosterior  portion  of  the  liard  pala'e 
(Figs.  41,  42,  and  100).  They  articulate  willi  each  r>tlier  in  the  posterior  jiortion  of  the  midille 
jialatine  suture,  and  with  the  palatine  processes  of  the  nia.xiila  in  ihe  transverse  palatine  suture. 
.\t  the  ])osterior  extremity  of  tlie  median  suture  tlie  two  palate  ixmcs  logetlier  fonu  the  posterior 
nasal  spine  (Figs.  S?  and  100),  as  well  as  the  ]io-.HTior  iiorlioii  of  the  nasal  cresi  upon  the  nastl 
surface  of  the  hard  palate  (Fig.  7S1,  and  their  ixistcrior  margins  form  the  lower  boundarv  of 
the  choana'  (Figs.  41  and  42).  The  rough  ])alatiiie  surfaci'  of  the  hori/oiiial  \<\mk-  (Fig.  too,', 
like  the  similar  surface  of  the  palatine  pn«(s,>  of  the  ma\illa.  exhiUil- jialaiine  spines  and  grtMives, 
and  also  presents,  near  the  posiero external  aiigK,  the  x'''""'"'  palatine  joramm.  one  of  the 
oriliies  of  the  pteryi^opalatim  laiial.  The  nasil  surfac,-  (JMg.  -,,1^  lioweM-r,  i-  snxMilh  anil 
distinctly  concave,  like  the  corresponding  surface  of  the  palatine  prods-  of  ihe  maxilla. 

'ilie  perpendicular  plate  of  the  jialate  Ix.nt'  i-  narrower  and  thinner,  but  loni.'cr  ili.in  the 
hori/.onlal  one.  Its  maxillary  surjace  (Fig.  84^1  is  a].plied  to  ihr  lough  siirfatf  of  llir  poslcrior 
portion  id"  the  na-al  surface  of  the  maxilla  and  abo  partl\  lit-  i;i  from  of  and  parlb  closes  iln 
orifice  ot  tlu  ma\illar\  sinu-.  Its  internal  or  i;./,v.;/  surjace  d-'ig.  85)  forms  the  posterior  portion 
of  til.  Literal  n.isd  wall  1  Figs.  101  and  102),  and  pn-enis  two  hori/oiilal  parallel  ii<lges,  a  disiiiii  I 
interior  one,  the  (omliai  cresi  (Fig.  85),  for  the  ailaihment  (d"  the  inferior  Itirliinated  Ihmk  (I'lu's. 
101  and  102),  and  a  less  pronounced  sujierior  one,  thi'  ittimoidal  crest  1  Fio.  ,S(i.  for  the  middle 
turbinated  lx)ne.  M  the  posterior  berder  of  ihe  perpendii  ular  plate  lliere  is  a  ;'.;  "'ve,  llu 
ptcry,i;o palatine  t;roo-ee  (Fig.  84!,  which,  with  the  >imilarlv  nanuil  grooves  of  the  maxilla  (see 

•  'K  ,••;  -'"'I  ■■:  1:1:  |-f.  ._i^--!i!  j)nn.vr-.  td  ;iie  rijiiie;;ia:!  iione  ;  see  riU'.  ^  ^ :,  iorjo-  !iu  p!,T\-:^,:p.;;.l 
tine  canal,  wlio-e  inferior  exiremity  is  the  |ire\ioii-lv  mentioned  i:rcaler  palatine  Jorannn.  Iti 
ils  vitinily  are  also  the  orifices  of  .several  smaller  lateral  tamilication-,  the  palatini  niiials.  mosi 


70 


ATLAS    AXD   TEXT-BOOK    OF   HUMAN   ANATOMY. 

Fig.  83.— The   r.uiu    i)alatc   bone   seen  from  behind  (j). 

Fig.  84.— The  rijjht  palate  bone  seen  from  the  outer  surface  (\). 

Fig.  cSs.  -The  riijht   palate  bone  seen  from  the  inner  .surface  (}). 

*  =  surface  whicli  lompktis  the  pliryKoid  fossa. 
Fig.  86.— The   left   nasal   hone  seen   from   the  outer  surface  ({). 
Fig.  87. — The  left  nasal  hone  .seen  from  its  inner  surface  (}). 
Fig.  88. —The  right  malar  hone  seen  from  the  outer  surface  (}). 
Fig.  8q.— The  right  malar  bone  seen  from  the  temi)oral  surface  (\). 


of  which  perforate  the  pyramidal  process  and  end  on  the  hard  jjalate  as  the  lesser  palatine 
j  Oram  ilia. 

Of  the  three  j)rocesscs  of  the  ])alate  Ixine,  the  pyrniiiidnl  process  or  tuberosity  passes  back- 
ward from  the  junction  of  the  two  ])lates  of  the  Ixine,  fillinK  in  the  jjtervgoid  notch  of  the  ptcri'- 
goid  processes  of  the  sphenoid  bone  and  coinplelin},'  the  pterj-god  fossa. 

The  other  two  prcKes.scs,  the  nrhiial  and  the  sphenoidal  processes,  are  given  of!  from  the  upper 
portion  of  the  perpendicular  ])late  alxive  the  ethmoidal  crest,  and  arc  separated  from  one  another 
by  a  deep  notch,  the  sphenopalatine  notch  (Fi^'s.  84  and  85).  The  inferior  surface  of  the  body 
of  the  sphenoid  bone  con\erls  this  notch  into  the  sphenopalatine  jorainen  (Fig.  102),  an  imi)ortant 
communication  Ixtween  the  ptcrxgopalatine  (sphenomaxillary)  foss;i  and  the  nasal  cavity, 
which  gives  passage  to  ves.sels  and  nerves  (see  page  78). 

The  orbital  process  (Figs.  8;,  8^,  and  (>0)  is  the  anterior  and  larger  of  the  two  processes, 
and  is  directed  outward.  Its  upper  surface  forms  the  most  [wsterior  [Kjrtion  of  the  floor  of 
the  orbit,  articulating  with  the  lamina  papyracea  by  the  j)alat(K'thmoidal  suture  and  with  the 
orbital  jwrtion  of  the  maxillu  by  the  palatomaxillary  suture.  Its  anterior  surface  is  closely 
ajiplied  to  the  maxilla,  while  the  internal  one  has  an  irregular  Ixjundan.-  and  articulates  with 
the  ethmoid  lab\rinth,  where  it  assists  in  closing  in  -^ome  of  the  ethmoidal  cells,  the  palatine 
cells.  The  orbital  jjrfxess  is  also  in  contact  with  the  external  surface  of  the  Ixnly  of  the  sphenoid 
bone  by  the  s])hen(X)rbital  suture,  and  forms  I'.ie  posterior  |)orti()n  of  the  inner  margin  of  the 
inferior  orbital  ispheiiomaxillarv )  ri>.sure. 

The  thin  i)osteri<)r  splienoidal  process  iFigs.  8;„  85,  and  101  1,  directed  internally,  is  a])plied 
to  the  ala  vomeris.  to  the  inferior  surfice  of  the  b<Kly  of  tlu'  sphenoi.l  Ixwc,  and  to  the  sphenoidal 
conch.e  (sphenoiila!  Iurbin;.ted  lx)nisi,  and  also  ]iartly  closes  the  orifKc  of  the  sphenoidal  sinus. 


Tlu'  (..ii.iU-  Uiiif  is  fMrtniil  in  nitmhrani  in  llic  ihir.l  f.  i.il  nmnlli  an. I  is  aln-ail\  .Ksitiid  at  .ilmut  ill.  im.l.il,-  ii( 
thi'  f.  t.il  lit.-,  but  likr  !hi'  uj^Hi  jaiv  il  is  ralli.r  sh..rt  in  111.'  nnvl>..rn 

'111.  ..rliil.il  -iirfa..-  ..f  ihi-  ..rhiial  pr'Kcss  is  s.ini.  linns  iimisd.illy  larKi-.  an.l  ili.-  width  ,,f  th>'  |nr|u  ii.li.  uiar  plate 
is  sulijril  I.)  Rrcat  indiviilual  \.iriatii.n. 

THE  ZYGOMATIC  BONE. 

The  zyKomalic  cr  malar  Ix.nes  (Figs.  88  and  8<))  are  three  sided,  flat,  strong  bones  which 
form  the  prominence  of  the  cheek.     They  artic\datc  with  the  fnmtal,  .sphenoid,  and  ma\illar)- 

l><)ni'>i    ^Fi"*       '"    a"'l     •>***      Tn.l    ..l.j.>    >•  ills    lis.,   •j.^s. ...... .1    I...,.,.    U..    _. ft'-       1- !-•     '      I       •! 

over  the  temporal  fossa  (Figs.  T,q  and    \o)  (the  suiures  are  dest  ribed  upon  pages  ^7  and  80). 
The  small  orbital  plate.  ], laced  at  right  angles  to  tht  malar  surfaie,  a.ssists  in  the  formation  of 


Orbital  pnurss 
Sphenoiildi  pmrss 


Siihciiopalatine 
notch 


Orhiliil 

piVff^s 

Horizontal  plate 


I'oslirior 
IHISIll  spi'/ii- 

Maxilliiiy  siir/'df 


f-'i'r.  84. 


I 'tiiygopaliiliiir  !>roovc 
if^rcatir  /nihitiiit'  fontnien) 


Xiisii/  lofiinuii 


Hfr.    SO. 


I  roiitii- 
s/i/iiiiiin/ii/ 


<>r/>itii/  siirftin 


\ 


I  'tnys^opiiliiliiw  !,'yvi()i'/' 
Perpendicular  plate 

Orhiliil  piiH 


t  thmoi- 
iliil 


.V 


V'ss 

>/'//f  fii*/iu/i/'  '       nut,!' 


-V 


I'yniiniiltil 
fig.  Si 


f-'i''.  S5. 


I  (  s^(^  /I  :,'iin:li 
I  I'm 'III  n 


lhiiii<ii!iil  I'/iiiMv 


\ii^iil  fonriu'ii 
filr.  S7. 


I  IVIll,< 


Vi;omiil!,<i-orl>itiil  l',>niiiniiii  /-a    V''"'"'"'/i"' 

.       MM         iii'.i.  .  .  . 


ihhiliil  \iiiitirr 


/ilOii^-. 


/v:;,;i.,i,n,''"f"'i' '■"•''  ""■''•"" 
hiltil  /{ 

■,iii>in  ^ 


1 1  tniiiiriil   ntjt. 


^Ill/ill     yllliilll 


1 1  ill/l,'l,l,'    -.III  lilil 


^       1 1: 


it^. 


'.  SO. 


-"..-  ( 


^?^    % 


1 


3&Ji' 


-*fe-  -^^^i 


I 


THE   BONES   OF   THE   SKULL. 


71 


the  orbit.     Tho  malar  l)Gnc  i^rcscnts  three  surfaces,  the  \add  or  malar  surlacc,  the  poslcnor 
or  temporal  surjace,  and  the  orbital  siirjace  formed  by  the  upper  surface  of  the  orbital  ,)late. 

The  or6//a/  .w(r/arr  is  slightlv  concave  and  its  anterior  border  forms  part  of  the  infraorbiial 
margin  (Fig.  95).  It  articulates  with  the  orbital  surface  of  the  greater  wing  ol  the  sphenoid 
bone  is  usually  separated  from  the  orbital  surface  of  the  maxilla  hv  the  injcrwr  orbital  (spheno- 
maxillary) fisurn;  and  forms  a  portion  of  the  fl(K,r  and  of  the  outer  wall  of  the  orbu 
Upon  this  surface  is  the  zvgomaticoorbilal  joramnt  (Fig.  88),  lea.ling  into  a  branching  canah 
whose  cNtcmai  orifices  are  the  zvi^omaticolcwporal  an.l  zviiomatirojaaal  joramnu,,  although 
frequently  these  two  canals  are  entirely  independent  of  each  other,  in  which  case  there  are  two 
zygomaticoorbital  foramina  (l"ig.  88). 

The  quadrilateral  malar  plate  possesses  a  convex  malar  surface  and  a  s.  ghtly  concave 
temporal  surface.  It  articulates  bv  me.-ms  of  its  anterior  rough  margin  with  the  zygomatic 
process  of  the  maxilla,  an.l  in  common  with  the  orbital  plate  it  gives  off  the  jroutosphnuwtal 
procns  (Fi"s.  88  and  89),  which  j.asses  ui)wanl.  forming  the  outer  margin  ot  the  orbit,  and 
articulates  with  the  zygomatic  process  of  the  frontal  U>ne  an.l  the  zygomatic  Ix.rder  of  the  greater 
wing  of  the  sphenoid  tone.  The  temporal  process  ,,asses  posteriorly  to  form  th.'  zygoma  bv 
articulating  \vith  the  .'.vgomatic  j^rocess  of  the  temporal  Iwnc  (Figs.  39  and  40'.  I  he  sutures 
between  the  zygomatic  and  the  adjacent  lH)nes  hinv  been  previously  r.ote.l  (page  ^7\  ''md  will 
be  reviewed  in  another  place  (page  80).  The  malar  surface  a,ovs  the  zy,>;omaticojae,al  joramev 
(Fig.  89);  the  temporal  surface,  the  =\\qomalicolempor<il  jorameit  (Fig.  88). 


icnics  tci  <lfVoli.|)  about  itir  '.n'RinninK  ..f  thf  ihinl  f.ial  ni'ituli 
ns  of  the  bum-  iiri-  M-parated  ivcn  in  ailuU 


Thi-  zvg(imali(  t»)ni'  h  furnicil  in  mimliriini  anil  iiimmcnu-s  tci  ilfvi'|i>|) 
from  two  scimrati'  (I'ntiTs  of  os.silKaliim.      In  r^ri   insUinri'S  the  tw  purUn 

:     :  lumr.  whi,  h  n,  ,v  iK.  socn  a,  aU.u,  U. ..1-  of  ih.- , sine  .ho  bon,-!,.. anally  push.-,  ou,..n. .  nnn. 

i,.  .l.:v.lopn».n,  an.l  .luring  ih.  Rnnv.h  „f  th.  in-,livi.lual,  i.  bapp.ns  .ha,  in  on.-half  of  .h.  -ponnu-n.  .h,-  .rh,.al  .urla. 
no  lonpr  forms  ono  of  ihr  l>.mn.larirs  of  thr   nf.rior  oil.ital  ( -uhcnomavillarvl  hssurr. 


THE  MAT'DIBLE. 

The  I  le  (Figs.  90  to  9U  is  a  singk  In.ne,  an.l  i^  the  only  t)one  of  the  skull  whi.h  is 

connecle.1  remainin^  b  •       bv  a  joint  instea.l  of  by  sutures.     It  consists  ot  two  main 

,K>rtions,  a  u„ly  an.l  two  rami.  Fhe  upper  en.l  of  eacli  ramus  is  composed  of  two  |.r(K-esses. 
an  anterior  pointed  corom,i<l  l>roress  an.l  a  i.osleri..r  roun.le.l  eowlyhul  proee^^  (I'lg.  .),V.  tl. 
two  being  separatc.l  bv  the  ,wl< I,  oj  the  ma,„tible  isi^moi,!  ,wt,ln.  The  body  of  the  nian.lible 
is  an  apprt.ximately  paral..loi.l  Ix-nv  i>late  fn.iu  the  ,,osteri..r  extremities  of  wliu  h  ihe  ram. 
pass  vertically  upward.  Its  inferior  margin  is  terme.i  the  base  of  the  mau<i..,le;  ilie  su,,en.,r 
margin  is  the  alveolar  portion,  an.l  contains,  in  the  adult,  sixteen  dental  ahv-.h  L.r  ilu'  low.r 
teeth  which  are  separated  fn.rn  each  ..ther  bv  the  int.n.h.  ..lar  s.pta  The  free  margin  of 
the  alveolar  ,.r..cess  is  calle.i  the  alveolar  border,  an.!  the  n-.l^  -f  th.  t.etli,  parti,  ularly  thus,, 
of  the  front  ones,  expan.i  the  thu,  b.ny  mas.  ..f  the  pr.Kcs.  an.l  pn,.lu.e  hngitu.hnal  n.lg.s 

uiKin  the  surface  of  tiie  Ikiuc,  the  alveolar  juf^a  (Fig.  <)o). 
'       „..  .,.,,.  ,         f,       ,  f  .L,.    L  ,1..  ..(■  .1...  ......  ,i;M,.  ..sliiliils   ;i    ri)ii(di  ni".)ie.  liiHl, 

i  in- iiii.i.ili 01  Uu  external  surlace  ol  tnv  DOvi-.    -i  " -        _    . 

the  menial  protuberame  (Fig.  ^ro),  which  marks  the  uni..n  ol   the  orginallv  separate   lialves  ..1 
the  tone  (Fig.  8„i,  an.l  to  <  ilher  si-ie  of  this  projection  an.l  lowani  the  base  of  the  man.lible 


72 


#1 


ATLAS   AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 

Fig  qo.-Thc  mandible  seen  from  in  fn.nl  (\). 

Fig".  9.  -The  mandible  seen  from  the  outer  surface  {{). 

r-         ,      TV.P  mindible  seen  from  below  (\)- 

p;;;:  ;li     -^ilftf  the  mandib.  seen  from  the  ^ner  surface  («. 

FIG.  94.-The  hyoid  bone  seen  from  in  fron   and  abo^e  (-,)• 


.  ..  ...  :....     Al.ve  ana  to  the  ^^^^^^ ^Z:^:^^ ^^^^^^^ 

joranun,  giving  exit  to  the  vessels  and  ^^^^^^^^^  greater  portion  of  the  body  of 
:,f  ,H,  .nandibnlar  m]erior  JaUal)  canal,  -^^^^^^  ^J^^^.  ,f  ,i  i^ody  a  smooth  ridge, 
the  mandible.     There  is  also  to  be  o^^senc^  ui    n  t      o  U  ^^^^^^^^^  ^^^^^^.^ 

the  oblique  li,u.  which  passes  downward  f-m  U.    r  k>   c  ^J  ^^^^^^^  ^^^^^^^^^^^  ^^.^^ 

a^vay,  and  finally  entirely  disappears  somewhat  to  the 

90  and  90-  .   ,     ,     I      f  ,h,.  i^mdible  (Fi"s.  02  and  c),V)  exhibits,  to  either  side 

"^     The  internal  surface  of  the  bcxly  of  ^^e  ™hbl  ^.   ,,^_  .^  ^^,^.^,^,^,,, 

of  the  median  line,  a  shallow  deprc.su,n  -'-  ^^^^  ^  2,  a  J.  this  there  i.  a  ,hort,  rough, 
Uu.  mser-ion  of  the  anterior  IxUy  of  the  '»'f-  "  ^^^X' a  paired  structure  an.l  son.etimes  also 
irregular  prominence,  the  ,.«/././>;-,  ^^^^^^  ^'^^  ,,,,,,hvoid  and  geniohvoglossus 
shows  a  further  transverse  sul.ln.s.on;  .t  «'^^  ""^^,  ^^^^^^'.hallow  depression  which  lodges 
niuscles.  To  the  outer  side  of  the  mental  spme  ^^  ;;';,,,  „L  is  the  termination 
Uu.  sublingual  s^divary  gland,  and  between  tesb  ^^^^^  ,„.,   from  alx.ve  downwanl 

„f  U.e  rough  ,„yloM  Inn:  which  i;--;/:2le3  gives  nri.in  to  the  mvlohvoid  nmscle. 
,„.,„  uu.  inner  surface  of  the  l.dv  of   he  -  -d  Ic^.m  ■        .      ^^^,^^^  ^^^^^^^^^^^^  ^^  ,^^ 

■      A  certain  distance  below  the  mvloh>oKl  hue  th  r.  *^  „„,  ,,,,u- 

-:,  i::,;::;;:":,  .;::::--:r::i:;:;.: -  ^. « -  --"  •"- 

Mon  for  the  .ubmaxiUary  glan.l.  ^  ^^^     .^„,l  ;,  ,^,jh  broader  and 

K.ch  ramus  forms  almost  a  r„bt  -fl'-^^^^^'  ,,;,,,  ,,,.  ,,.0  ,,nKesses.  an  anteri..r 
„„„,,  ,Han  the  IhkIv.  It  passe,  upward,  '^ -'  "  ;;'^  J;^^,  ,,  „,■  notch  of  the  mandible 
anonoul  and  a  ,,o.tenur  .n,uHo„!  I^rou  •  ,  whuh  arc  scparat        . 

ahe  Mi-moid  notch).  ,.vi..rnal  surface  and  an  inl.rnal  surface. 

The  ramus,  like,  tl.c  lx>dv  of  the  bone,  poss.^se.  an      U mal  .  ^^^^^^^  ^^^^^^^^^   ^^^,^_  ^^,^^ 

,  ,.nion  of  the  latter  being  directed  toward  ^ ^^^^  ^  ,,^  ,,^,  i„^,,,,„  of  the  masseter 

for  :hr  insertion  of  llie  internal  pterygoid  muscle.  ^^  ^    _^^^    „,„„.r,hnlar  iiuirrior  dcnlar) 

Al  .dHHU  .he  middle  of  the  rann.s  uie.  -^-^-;;--:;^  ,;,„„i ,  ,„„./*  which  passes 
/«nimnMFig..,,V.thesupenoron.-'-.ngofth.  m.,m// 

,      ,  ,    v„n,l  Ih.   numal  fwr..nur.  aln.oM  tu  tlu  nud.an  hnv  ..n.l 

,i...  ,„T  .,,,..11  l.,u  r,,l  r..mitK:,nM„.  «h.  h  L-l  ."  "'^'  '^l'""  "'  '^'^  "''"""• 


^■f^K?a^ 


■„  tv.  .f<;::',-(TS 


■    nir  iin-TTi-mimiTrriia—Mi 


()l)liiliii'  liiii 


Miiiltil  l\<niiiifii 


Mtnldl  liihiirh         .Wiiitnl  proiiiliirdiur 
'Body 


Ramus 


//''.   00. 


1  m 


.\lvi;<!,ir  /•.".III 


< 'iimiii'/tl  /mfif^ 


Body 


WiiiliJ  liUii/iuii 


Wild/  I'l  till    niaiulii'l:- 

I'll  lyi^iHil  lipris^iitii 

;-^,      lliiiil  01  i;<inlvli<nl  pioif^s 


Ramus 


f  II'.   III. 


Il;.^h'    illlil\^itilli-   lllh,i\-\ll\- 


n 


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THi:    BOXES   OF  THK   SKIILL. 


73 


obliquely  through  .nc  mandible  to  the  mental  foramen  and  transmits  the  inferior  dental  vessels 
and  nerve.  A  thin  tongue-shaped  bony  plate,  the  lingula,  overhangs  the  anterior  margin  of 
the  foramen. 

The  coronoid  process  is  llattenefl  from  side  to  side  and  terminates  in  a  more  or  less  sharp 
apex  which  gives  attachment  to  the  temporal  muscle.  In  the  ])r()longation  of  its  anterior  mar- 
gin runs  the  previously  described  oblique  line,  and  passing  from  its  base  to  the  region  of  the 
last  molar  tooth  is  a  ridge,  the  buccinator  crest  (Fig.  93),  for  the  origin  of  the  buccinator  muscle. 

The  condyloid  process  terminates  above  in  a  condyle,  whose  head  (Fig.  91)  is  sei)arated 
from  the  base  of  the  ])roccss  by  a  constriction  known  as  the  neck  (Fig.  92 ).  The  articular  surface 
itself  is  ellipsoidal  and  its  longitudinal  axis  is  i)laced  almost  transversely,  although  directed 
somewhat  ])osteriorly,  so  that  the  condyloid  jjrocess,  in  contrast  to  the  coronoid,  is  c()m])ressed 
from  before  backward.  U])on  the  anterior  surface  of  the  neck  of  the  condyle  there  is  a  shallow 
pterygoid  depression,  which  receives  jiart  of  the  ins-rtion  of  the  external  ptengoid  muscle. 

The  lower  j.i\v  is  formed  in  memhrane  about  Mt<  kel's  c  arlilane,  u  larlilagc  c.f  the  visceral  skelitcm  wliic  h  niark^ 
the  position  of  the  adult  mandible.  The  first  center  of  ossifuation  .,  ipears  in  the  M'lond  fetal  month  u|H)n  Uith  si(Us 
externa!  to  Meckel's  cartilaKe;  a  second  center  appears  above  the  first,  and  the  tv.o  unite  in  su(  h  a  manner  that  ihey 
form  a  groove  which  is  open  alxne  for  the  reception  of  the  teeth.  Kven  a',  birth  the  tvso  halves  of  the  mandible  are  usually 
separated  by  a  synchondro.sis,  and  they  do  not  unite  until  the  first  year.  Tlic  mndyloid  proi  ess  is  preformed  in  c  artilage 
and  is  developed  by  the  <Iire(  t  transformation  of  the  cartilage  into  bone.  The  Icwir  jaw  of  the  ncw-lxirn  is  very  Ion, 
possesses  no  alveolar  portion,  and  the  ramus  is  still  but  pcxirly  developed  and  f..rms  a  very  obtuse  angle  with  the  body! 

THE  HYOID  BONE. 

The  hyoid  bone  (Fig.  94)  is  a  small  horseshoe-shajied  structure  situated  in  the  base  of  the 
tongue;   it  does  not  articulate  with  the  skull  but  is  connected  with  il  Ijy  the  stylohyoid  ligament. 

It  consists  of  a  bod\-,  from  either  side  of  which  proceed  the  f^reater  and  the  lesser  cormia. 
The  '■  )r/y  is  slighth-  curved  horizontally,  the  anterior  surface  being  rough  and  slightlv  convex, 
the  ])()sterior  one  smooth  and  slightly  concave.  Tlie  i^realer  cornua  are  long  and  thin  and  are 
connected  to  the  Ixxly  either  by  b.)ny  tissue  or  by  cartilage,  more  rarely  bv  fibrous  connecU\e 
tissue  or  by  a  joint.  They  i)ass  horizontally  outward  from  the  Ixxly  of  the  bme,  and  are  directed 
backward  and  ually  slightly  upward,  their  ends  exhibiting  a  l)ulboiis  thickening.  The  lesser 
cornua  are  fretjuenlly  cartilaginous,  and  arise  clo.se  to  the  ba.ses  of  the  greater  ones;  lhe\  are 
directed  ui)ward,  howe\er,  and  also  outward  and  backward.  They  are  much  shorter  than  ihe 
greater  cornua  and  are  connected  with  the  styloid  process  of  the  temnoral  lx)ne  1)\  the  stylo- 
hyoid ligament.  The  nature  of  their  attachment  to  the  iiyoid  bone  is  subject  to  considerabk' 
variation. 


The  hyoiil  Inme  is  i.."-'.,niK(l  in  larlilage  and  arises  chiclly  from  the  seiond  lir.mc  hi.il  anh  (ih.  lucid  art  hi,  the 
greater  lornua,  however,  representing  the  third  .m  h.  The  body  ([wo  centers)  and  the  greater  .ornu.i  (omnienM  in 
Ossify  at  birth,  the  lesser  lormia  at  a  imu  h  later  perio.!.  Sometimes  the  1i-smt  ..irnu.i  extend  f.ir  into  the  stylohyoid 
ligament  (see  page  no),  just  as  the  styloid  proiess  does,  the  two  l,ones  having  ,i  .ommin  embryonii  origin. 

THE  ORBITAL  CAVITIES. 

Each  orbit  (Figs.  95  to  ()())  is  a  (|uadrilateral  pri.sniatic  space  having  the  shape  of  a  tall 
horizontal   i)yramid,    the   apex   of   which   is   situated    i)()steriorly   in    the    region    of   the   optic 


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74 


ATLAS   AND   TEXTBOOK    OF   HUMAN   ANATOMY. 


Fic.  95.— The  left  orbit  seen  from  in  front  {]). 

Fk;.  96.— The  median  wall  of  the  left  orbit,  the  outer  wail  having  Ijeen  removed  {\). 
Fk;.  97.— The  outer  wall  of  the  right  orbit,  the  medirn  one  having  l)cen  removed  (',). 
In  all  these  figures  the  frontal  Imne  is  vi,>let;   the  ethmoid  orange;  the  lachrymal  pink,  the  sohenoid  creen;   the 
nasal,  parietal,  and  zygomatic  Iwnes  white;  and  the  palate  bone  blue  .  b         . 


foramen.     Its  base  is  a  quadranj.'lc  with  rounded  comers,  and  foiros  the  entrance  to  the  cavity 
(ad litis  orbita). 

The  four  walls  of  the  orbit  are  designated  the  superior,  the  internal,  the  cxtem.ii,  and  the 
inferior.  Since  thcic  is  no  sharp  dividing-line  between  the  superior  and  internal  and  between 
the  internal  and  inferior  walls,  and  also  since  such  a  dividing-line  is  partly  absent  between  the 
external  and  superior  wall,  the  pyramidal  orbital  space  [jossesses  for  the  most  part  no  sharj) 
angles;  inrleed,  posteriorly  the  pyramid  has  ])ractically  but  three  sides. 

Each  orbit  is  formed  by  seven  bones:  the  frontal,  the  sphenoid,  the  ethmoid,  the  lachrymal, 
the  maxilla,  the  zygomatic,  and  the  luilatine.  The  sutures  Ijetween  these  bones  arc  descrilied  on 
pages  79  and  80.  The  upper  wa';  'ir  the  nxif  of  the  orbit  (Fig.  95)  is  formed  bv  the  orbital 
portion  of  the  frontal  Iwne,  and  in  '.he  jjosterior  portion  also  by  the  lesser  wing  of  the  sjjhenoid 
bone.     It  is  horizontal,  smooth,  and  slightly  concave. 

The  inner  wall  ^Fig.  97)  is  formed  anterioiiy  by  the  lachrvTn:  1  bone  and  posteriorly  by 
the  lamina  papyracca  of  the  ethmoid  lx)nc  and  by  a  sn.iU  portion  of  the  ala  parva  of  the  sphenoid 
(near  the  junction  of  the  inner  wall  with  the  roof).  Below  the  lamina  jiapyracea,  the  orbital 
surface  of  the  maxilla  extends  upward  from  the  tloor  upon  the  inner  wall,  and  its  frontal  process 
also  forms  a  narrow  jrortion  of  the  inner  wall,  internal  to  the  lachrymal  Ixine  and  immediately 
adjacent  to  the  internal  orbital  margin.  The  inner  wall  of  the  orbit  is  approximately  vertical 
and  its  anterior  jtortion  exhibits  the  fossa  for  the  lachrymal  sac. 

The  floor  of  the  orbit  (Fig.  99)  passes  quite  gradually  into  the  inner  wall,  and  its  posterior 
I)ortion  is  separated  from  the  largest  (jxisterior^  portion  of  the  outer  wall  by  the  inferior  orbital 
(si)henomaxiliary)  fissure.  Its  greatest  [lortion  is  formed  by  the  o^-bital  surface  of  the  maxilla, 
only  a  small  posterior  jxirtion  being  formed  by  the  orbital  j)rocess  of  the  i)alate  bone.  In  the 
anterior  portion  of  the  orbit  the  zygomatic  bone  also  forms  a  narrow  strijj  of  the  lloor,  but  the 
extent  to  which  it  takes  part  u  subject  to  considerable  variation  (see  page  71).  The  inferior 
orbital  wall  is  quite  sm<x)th  and  is  abnost  exactly  horizontal  (slightly  inclined  outward,  forward, 
and  downward). 

The  outer  wall  of  the  orbit  (Fig.  97)  is  the  most  i.solated  of  all,  since  the  two  orbital  fissures 
separate  from  it  the  remaining  walls  in  the  posterior  portion  of  the  orbit.  I'he  inferior  orbital 
(si)henomaxillar\)  fis.sure  scijarates  more  than  half  of  the  length  of  the  outer  wall  from  the  lioor, 
and  one-third  of  its  extent  is  sejiarated  from  the  roof  by  the  .superior  orbital  (sphenoidal)  lissure. 
It  is  practicallv  formed  by  two  Ixjnes.  the  orhit.n!  s'.irf.xr  nf  tb.-  ^^natcr  -.ving  of  the  sijhenuitl 
bon<'  contributing  the  posterior  portion,  and  the  orbital  surface  of  the  zygomatic  Ixine  the  anterior 
})()rtion.  The  latter  i)ortion,  however,  also  contains  a  part  of  the  orbital  i)ortion  of  the  frontal 
bone,  which  extends  downward  more  or  less  from  the  roof.     The  outer  wall  of  the  orbit  is  slightlv 


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Xd'^ul  hoiw 


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THK    nONKS    OF   THK   SKUI.I,, 


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concave  and  is  not  exactly  vertical,  but  directeii  somewhat  from  aljove  downward  and  from 
without  inward. 

The  margins  of  the  orbit  are  known  as  the  sujjraorbital  and  the  infraorbital.  They  are, 
of  course,  connected  at  their  extreiiiilies  by  the  lateral  walls  of  the  orbit. 

The  supraorbital  margin  (Fig.  9ft)  is  usually  sharjjer  than  the  inferior  one:  it  is  fornu'd 
by  the  frontal  lK)ne  the  vertical  plate  and  the  zygomatic  proce>-)  and  contains  one  shallow 
notch  or  two  <leeper  ones,  the  supraorbital  and  jroiilal  noli  lies  or  joramiita  (Fig.  ();),  which  tran>- 
mit  the  frontal  and  sujjraorbilal  vessels  and  nerves.  The  frontal  hone  exiends  lower  down 
internally  than  it  jIocs  externally.  The  infraorbital  margin  (Fig.  t/j)  is  formed  internally  ijy 
the  maxilla,  and  externally  by  the  zygomatic  ixjne,  these  Ijoncs  extending  intirnaily  and 
cxtemallv  as  far  as  the  frontal  lx)ne.  \  i)orlion  of  the  internal  margin  (Fig.  ();)  is  furnished 
by  the  anterior  lachrvmal  crest  of  the  frontal  prmess  of  the  maxilla,  and  its  smcxHhest  jvortion 
is  .situated  alK)ve  this  crest.  The  external  margin  (Fig.  97)  is  formed  by  tlie  zygomatic  l)one, 
particularly  by  its  frontosphenoidal  process. 

The  following  foramina  and  fissures  lead  either  into  or  from  the  orbit: 

1.  The  opllc  joramcii  (Fig.  9O),  situated  in  the  nnit  of  the  lesser  wing  of  the  sjilunoid  lx)ne, 
leads  from  the  cranial  cavity  to  the  apix  of  the  orbit  ami  tr.msmits  tlie  optic  nerve  and  th( 
ophthalmic  artery. 

2.  The  supirior  orbital  (sijhenoidal)  jissurc  (Fig.  95),  between  the  greater  and  lesser  wing 
of  the  si)hcnoid,  also  leads  from  the  cranial  into  the  orbital  cavity  and  ininsmits  the  ojiiithalmic, 
oculomotor,  trochlear,  and  alxlucens  nerves  ;md  the  .sujierior  ophllialmii  vein.  This  fissure 
se])arates  the  outer  from  the  U])i)er  wall  of  the  ori)it.  Its  inlern;il  portion  i-.  wide;  its  external 
j)ortion  i.s  narrow  and  closc<l  by  a  membrane. 

,V  The  injcrior  orbital  (s])henoma\illary)  fissure  (Fig.  05),  Ixlwien  the  maxilla  iiid  the 
orbital  process  of  the  ])alate  lK>ne  on  one  side  and  the  gre;iter  wing  of  tile  sjiheiioid  Ixme  or  the 
greater  wing  and  the  zygomatic  lx)ni'  on  the  other,  le;ids  from  tlie  pterygopalatine  (spiunoni.ix 
illary)  fos-sa  into  the  orbital  cavity  and  transmits  the  infraorbit;il  vessels  ;ind  nerve.  It  .separates 
the  outer  wall  from  the  tlix)r  of  the  orbit  and  is  larger  antem  exti  rnally  tli;in  it  is  ])ost('ro 
internally.  The  external  boundary  of  the  fissure  is  furnished  l)y  tiie  crista  orbiiali^  nl  ilie 
greater  wing  of  tlie  sphenoid  txme. 

4.  The  sujfcrior  oi)ening  of  the  uasolai hrymal  iitasal)  canal  (I'"ig.  1)9),  in  tiie  fos.si  fur  liu' 
lachrvmal  sac;  tliis  canal  leads  from  tiie  orbit, d  into  liie  n;isiil  i ..  il_\  .iiid  traiisniit>  the  na>o 
lachrymal  (nas;d)  duct. 

5.  The  anterior  itlimoiilal  joramcii  (Figs.  <);  and  ()(>),  jiiissing  from  tlie  orl)it;d  to  the  cranial 
cavity  and  transmitting  the  iinterior  ethmoida'    essels  and  nasal  luTNe. 

6.  The  posterior  ethmoidal  joramen  (Figs.  <)^  and  96),  le:iding  into  tht-  nasd  cavity  and 
transmitting  the  posterior  ethmoidal  vessels.  Hoth  this  and  the  preieding  foramen  are  siluate<l 
in  or  to  one  .side  of  the  frontiHthmoidal  suture  in  the  inner  wall  of  the  orbit. 

7.  The  zyeomaticoorbilal  joramen  or  jorainina  \V\'^.  (j;!,  in  the  outer  wall  of  tlu  o-bl'  i.ass 
through  the  malar  lx)ne  to  the  teni]M)r:d  fossa  and  to  the  f;ue,  and  tran->niit  the  ner\es  ,in  i  Is 
of  the  same  name  or  tluir  brarulus. 

8.  '{"he  entrance  of  the  injraorbital  laiial  (for  the  vessels  and   nerve  uf  the  same    name), 


ti 


76 


ATLAS    AND    TKXT-BOOK    OF    III  MAN    ANATOMY. 


Fig.    98. — .\  frontal  section  tliroujili  the  anterior  part  of  the  skull,  showing  the  orbits,  the  nasal  fo.ssx, 

and  the  ma.xillary  sinuses  (i). 
Fli;.    t)(). — The  lloor  of  the  left  orbit  seen  from  above,  the  roof  havint;  been  removed  (}). 
Fli;.  100. —The  maxilla,  palate  bone,  and  lower  ends  of  the  jiterygoid  i>roeess  of  the  sphenoid,  seen  from 

the  oral  surface  (the  hard  yialate)  ( [). 


leading,  to  the  infraorbital  foramen,  is    situated  in    the  lloor  of   the  orbit,      ll   commences  al 
the  inner  end  of  the  inferior  oruital  fissure  as  the  infraorbil  il  .groove  {Fi<,'.  ()q). 

Q,  The  jronlal  and  supraorbital  joramina,  situated  '     the  supraorbital  marf^in. 

The  orbit  contains  the  following  depressions  or  fossa-: 

1.  The  jossa  jor-  the  ladirymal  gland  (Fig.  69),  on  ihe  frontal  lx)ne  beneath  the  outer 
])ortion  of  the  sujiraorbital  margin. 

2.  The  trochlear  (lcpr(!:sioii  (Fig,  68),  also  on  the  frontal  Ixjne,  where  it  passes  into  the 
inner  wall  of  th'-  orbit,  for  the  attachment  of  the  iiuUey  of  the  superior  obli(|ue  nuiscle. 

_S.  The  jossa  jar  the  lachrymal  sac  (Fig.  ()<;),  situated  in  the  inner  wall  of  the  orbit  Ix'twcen 
the  anterior  lachrymal  crest  of  the  frontal  process  of  the  maxilla  and  the  posterior  lachrymal 
I  rest  of  the  lachrvmal  Ixme. 

The  onlv  groove  in  the  orbil  i^  liie  liijraorhilal  i^ronvc  (Fig.  {)H),  u|)on  the  orbital  surface 
of  the  l)0(lv  of  the  maxilla. 

There  are  several  ]irojections  into  the  orbital  cavity.  These  are  the  anterior  and  posterior 
lachrvmal  (rests  which  fomi  the  fossa  for  the  lachrymal  sac,  and  a  Ixinv  spine  u])on  the  greater 
wing  of  the  sphenoid  lx)ne  near  the  outer  margin  of  the  superior  orbital  lissure,  the  spiiir  jor 
the  cxirnial  rrcliis  muscle  ( I'"ig.  ()()\.  'Fhe  frontal  bone  occasionally  presents  a  trochlear  spine 
alongside  of  tile  lim  iilear  depression. 


Till  iirMl.il  u.ilU  v;u\  KN  .Illy  in  lluir  lliii  liiii  ^■,.  Tin'  ihiiun  ^1  w.ill  i>  ihi'  iiiiur  ■me,  Imlh  in  ihc  riKinti  ni  tln' 
lamina  |>.i|'yr,i,i  .1  "1  llic  (llinioiil  %iiu' .mil  iiNo  in  ih.it  of  ihr  lai  lirynial  Ixmi'.  llir  latl'T  lumr  even  Ihiiik  .nmitiniis 
(l(fiiliM  Tlu  r"A  "f  llir  '■rhil  nut  infn<|uiiilly  inntainN  .i  |iiirliiin  of  \\n-  fnmtal  sinus,  in  whiih  lax-  it  h,  holloa. 
Till  null  r  w.ill  is  u^u.ilK  ilu'  ihii  ki   I. 

THE  NASAL  CAVITY. 

The  l)on\  nas;il  cavity  (J-'igs.  ()o,  loi ,  anil  to.'  i  issubcHvided  into  two  symmetriial  na.sal  fossiu 
b\  ilu  iiavil  se|)tum,  which  is  fii<|uently  obliinu  and  not  exactl;,  in  thi  median  siigittal  plane. 
I'he  i.uitv  i--  liighi'st  jiisi  beiiind  tile  aiiUrior  nares  and  gradu.diy  Ihioiiu's  lowi  r  toward  the 
|ios|i  rior  nans,  ;ind  nine  of  liu-  Imuhs  of  thi-  skidl  the  nasal,  frontal,  etiinioid,  sphenoid,  maxilla, 
palate,  infiiinr  turbinated,  lailiniiial,  and  \oiiur  take  part  in  its  formation.  In  cat  h  nasal 
fossa  the  re  may  tie  ri  <  "ni/ed  a  riMif,  a  HcHir,  an  internal  w.dl,  .ind  an  evternal  wall.  The  anti  rior 
opening  of  ilu  two  iMin  nasal  fossa'  is  knnwn  .is  ilie  apertura  pirijormis  (anterior  naresi,  wliile 
the  posterior  upeniiig  of  eai  li  i>  the  choaiia.  I'he  former  i  I'igs.  ;;  and  ?8|  i^  Ixmndeil  l)y  the 
niisal  Imni's  ;uid  b>  tilt  frontal  pninsses  and  iKwiies  of  tin  maxilla,  wiiile  eai  h  t  lioana  (posterior 
iiari-i  (Figs.  41  and  4J)  !'«  imunded  by  tlie  palate  iMiiie.  the  internal  plate  of  thi'  plen'g'>id 
pHMess,  and  tin  IhxIv  iif  ilie  sphmoid  Ixini'.  Tin  nnif  of  the  nasiil  cavity  is  forme<l  anteriorly 
hv  till  twd  nasal  ixines  ,uid  liy   ihi    ;  isal  portions  of  tin    frontal  Ijoiies,  in  the  middle  b)  the 


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~,   ,.-»'..T_   f.'i 


s-v,,^, 


THE    BONKS    OF    TJIK    SKI  I.I. 


cribriform  plate  of  the  ethmoid,  and  jwsteriorly  by  the  IxkIv  of  the  s})henoid.     It  is  curvid  so  thai 
its  anterior  and  ])osterior  ]>ortions  also  form,  so  to  spea!;,  an  anterior  and  a  posterior  wall. 

The  lloor  of  the  nas;il  f  .ssii  (Fis-  79)  i^  formed  by  the  upi)er  surface  of  tlie  iiard  palale. 
composed  of  the  palatine  prinesses  of  the  maxilla'  and  the  hori/onial  ])lates  of  ilie  pala'i'  Ixmes. 
The  internal  or  median  wall  is  smooth  and  of  sim])le  composition,  the  anterior  ])orlion 
being  incom])lete  in  the  Ixmv  skeliton.  The  external  wall  is  extremely  comi)li(  ated.  Tin 
median  wall  (FI.l;.  72)  is  the  ;/<i,s(j/  scjiliDii,  the  antero-superior  portion  of  which  is  formed  by  tlie 
])eri)endicular  ])late  of  the  ethmoid  bone,  tlie  postero  inferior  portion  by  the  vomer.  It  i.- 
attached  atx)ve  to  the  frontal  crest  of  the  frontal  lione,  l)elow  to  the  nasal  crest  of  the  hard  palate, 
and  behind  and  at)ove  to  the  s])henoidal  crest  and  r  istrum. 

The  ext  rial  na.s;i!  wall  iFii,'s.  101  ard  102)  exhibits  three  ])eculiar  foliate  prominences 
the  free  mar^^ins  of  which  are  rolled  uj)  upon  tiiemsehe-;  these  are  the  liirbiiuiird  hones  or 
tondur  ihisalfs. 

The  inferior  of  these  is  an  indei)endent  l>one,  the  courlui  nasi  injirior.  It  is  the  largest 
and  longest  of  the  turl)inated  Ixmes,  while  the  superior  is  the  smallest  anti  shortest.  The  superior 
ard  middle  turbinated  ixmes  are  pnuesses  of  the  ethmoid  lx)ne. 

The  outer  portion  of  each  na.s;d  fossa  is  div  id'-d  into  three  (anals  by  the  three  urbinated 
Ixincs:  the  suprrior  meatus,  Ixtween  the  suinrior  and  middle  turbinated  lx)nes;  the  middle 
meatus,  txtween  the  middle  and  inferior  turbinated  Ixmes:  and  the  injerior  meatus.  Ix'twcen 
the  inferior  turbinated  Ixme  and  the  tloor  of  the  nasal  fossa.  .\lx>ve  the  su])erior  turbinated  Ixme 
in  the  su])erior  meatus  is  situated  a  deft  like  recess  known  as  thi'  sphenoethmoidal  reeess. 

The  iK)rti(m  of  the  nasid  foss;i  situated  Ixtween  the  imier  margins  of  tiie  turbinated  lx)nes 
and  the  na.sal  se])tum  is  termed  the  common  meatus  oj  the  nose.-  tile  posterior  portion  situated 
Ix'hind  the  ])osterior  extremities  of  the  turbinated  Ixxlies  i>  known  as  the  »</.v('  pharynx  or  naso- 
pharynreol  meatus. 

The  external  nasal  wall  is  formed  by  the  following  lx)nes:  the  ethmoid  (su|)erior  ]X)sterior 
f)orti(m);  the  nasal  surface  01  the  fnmtal  process  of  the  maxilla  (superior  anterior  |x)rti(mi 
and  the  nas;il  surface  of  the  Ixxly  of  the  lx)ne  (inferior  anterior  portion);  the  vertical  jilate  of 
the  palati'  lx)ne  (posterior  iiif:rii)r  ]H)rti(m);  the  inferior  turbinated  Ixmic  linftrior  middle 
]x)rtion);  and  the  'imer  surfaci'  of  the  lachrymal  lx)ne  ((piiti'  a  small  portimi  in  tlie  aiiterinr  part 
of  the  middle  ineat.i- '. 

In  additio!!  to  ;;m-  main  nasal  lavity  there  is  a  series  of  acci'ssorv  ia\ities;  liuse  are  the 
air  lontaining  cavities  of  the  tnajority  of  the  cranial  lx)iies,  parliiularly  of  the  maxilla,  frontal, 
sphenoid,  and   elhtnoid. 

There  is  a  large  nimilxr  of  openings  lending  into  the  nasal  ( a\il\ . 

((( )  The  foramina  of  the  i  ribriform  i)!ale  of  the  ethmoid  lx)ne  in  the  roof  of  the  nasd  t  avit  v, 
transmitting  the  olfactory  nerves  and  the  anterior  ethntoidal  vessels  and  ner\is. 

ift)  The  superior  orifice  of  the  imisive  lanal  iFig.  7()),  on  either  side  of  the  nasal  n\-\  in 
the  llfxir  of  the  n;vsal  cavitv,  which  transmits  the  terminations  i>f  tin  anterior  palatine  xessejs 
and  nerve. 

(f )  The  inferior  orilicc  of  the  nasolachrynial  lan.d  in  iht  inferior  meatus,  which  contain-. 
thi    nasolachrvmal   duel. 


iv??:^:;'^^;::.^ 


78 


ATLAS    AND    TEXT-BOOK    OF    HUMAN    ANATOMY. 


Fir,.  loi.— \'ic\v  of  the  lateral  wall  of  the  rij,'ht  nasal  fos.^^a,  the  nasal  scjnum  havinp;  liccn  removed  (IV 
Fic.  102. — View  of  the  lateral  v.all  of  the  right  nasal  fossa,  the   middle  turbinated  bono  having  been 
removed  (i). 

In    Ihcsc  limins    tin-    frontal  lione    is  vioht,  the  1:i(  hrynuil  pink,  the  rthm<  i     ..r;iTij;i-,  thr  maxilla    villiiw,  the 
palatini'  blur,  thi-  sphinoid  Rnin.  anil  thr  iithir  lionis  whiti-. 
Fic.   lo.v-  -The  left  pterygopalatine  fossa  seen  from  the  side,  after  the  n  nioval  of  the  zygomatic  bone  (i). 

Tlu'  ma.xilla  is  yiliciw,  ihr  pal  iti-  l«'ni-  blue,  the  sphcni)i(l  pn  in,  and  thi- 7.yf;omatir  and  tLm|K>ral  lionis  white. 


!(/)  The  lihilus  scwiliiiuiris  (Fig.  loi),  in  the  middle  meatus  in  the  region  of  the  infundib- 
ulum,  which  leads  to  the  orifice  of  the  frontal  sinus  ( Fig.  102 )  and  to  the  openings  of  the  anterior 
ethmoidal  cells;  the  middle  meatus  also  contains  the  orifice  of  the  maxillary  sinus. 

(<)  The  ojienings  of  the  midd'e  and  jMisttrior  ethmoidal  cells  in  the  superior  meatus. 

(/)  The  upper  and  posterior  portion  of  the  nasal  cavity  contains  the  sphenoethmoidal 
recess,  the  orifice  of  the  sphenoidal  sinus  (Fig.  102),  the  small  posterior  etiimoidal  foramen 
(leading  into  the  orbital  cavity  and  transmitting  the  vessels  of  the  same  name),  and  the  spheno- 
fxiUiliiic  jonnihii  (Fig.  102),  whiili  accommodates  the  ganglion  and  vessels  of  the  same  name 
anil  communicates  with  the  plerygojjalatine  (sphenoma.xillary)  fofsa. 


fc^ 


-i 


THE  ROOF  OF  THE  ORAL  CAVITY,  THE  HARD  PALATE. 

The  nxif  of  the  oral  lavity  (  Fig.  too)  is  f  )rme(l  by  the  hani  ])alate.  It  is  a  markedly  concave 
elliptiial  bonv  jil.ite,  composed  of  the  jialatine  ])r(H  esses  of  the  maxill.T  and  of  the  horizontal 
jwrtions  and  01  part  of  tiu'  ])yramidal  processes  or  tuberosities  of  the  palate  lK)nes.  It  jiresents 
in  the  median  line  the  median  i)alatine  suture,  upon  which  a  bon\-  swilling,  the  torus  pdlaliiius, 
is  occasionallv  observed;  it  also  contains  the  transverse  palatine  suture  and  sometimes  the 
remains  of  the  incisive  si'tuir.  .\l  the  anterior  extremity  of  tlie  median  suture  is  situated  the 
single  incisive  foramen,  by  whiih  the  bony  oral  cavity  cimimunicates  with  both  bony  na.  .il 
fossie;  ]M)ste'-'orlv  in  llie  iiori/onial  plate  of  each  jiahite  Ixuie  is  the  greater  jjalatine  foramen, 
and  the  pvramidal  proci'Ss  contains  the  lesser  ])alatine  foramina  (inconstant  1.  .Ml  these  foramina 
are  the  orificis  of  the  pler\gopalatine  canal. 

THE  PTERYGOPALATINE  FOSSA. 

The  plir\!^opalatine  or  sphciiciihixilhiry  jossit  d'ig.  10^ )  lies  between  the  anterior  surface 
of  the  jiterygoid  process  of  the  sphenoid  bone,  the  ]Hri)indii  iilar  portion  of  the  palate  bone,  and 
the  posterior  exlreniiiy  of  liie  maxilla.  It  i>  funnel  shaped  and  is  continued  direttly  downward 
into  the  iitervgojialaline  canal,  whicii  is  bounded  by  the  same  three  bones.  It  opens  oMt  supe 
riorly  into  the  interior  orbital  (si)henomaxillary  i  lissure  which  0  •inumicales  with  the  orbit 
and  e.Mernallv  the  ]iterygomaxillary  fissure  connects  the  ])terygopalatine  with  the  infratem 
fKiral  fossa. 

Ojjvning  into  the  pterygrjjKilatinc  t<>--n  an-  !!"•  j^'r^imrn  rnitirJum.  by  which  it  communicates 
with  the  cranial  cavity,  the  pirryKi'i'l  canal,  which  passe->  horizontally  backward  in  the  root  of 
the  i)terygoi(l  process,  and  the  spin  no  palatine  joramm,  hading  into  the  nasal  (a\ity.  'i'he 
fossa  contains  the  sphenopalatine  ganglion  of  the  niaxillary  nerve  as  will  as  arteries  and  veins. 


I'rontiil 
sinus 


Crista  iralli      -^'feSS 
Nasal  hones      ^  ■ 


Sii/iir/or  Inihinated  hone 

Parietal  bone 


I  einporal  hone 
Sphenoidal  sinus 


liasihir  portion  of  orripital  bone 
/yi^onuitie  areh 


rlulr 
/-VtliillhilroUiluil! 
tm-::ri!rti 


ll'nfii^   ^iiinliotnri\ 


I ninsverse  palatine  sntiire 


f-'itr.   101. 


I  rontal  s. 


Ori/iee  of 
frontal  ■<i>ni 


MiMIr  tio- 

liiiatrtt  /)(>//( 

Orifiir 

IllUlt.     ^Itlll> 
(  'fttii.:1fi 

/imr 
mtixata/ 
AtttiriiU' 


Infratemporal 
fossa 
Foramen 
ovale 


Spine 
of  sphenoid 

I'teryij^opalatine  fos->a 


Pyramidal  proee^^ 
of  palate  bone 

'  Hamnlar  proee--s 

Alveolar  foramina 


'orm  plate  < 
Sn/irrior  turbinated  hone 

'ifiee  of  ■^phen-^idal  sinifi 
Sphenoidal  \inns 

rior.     11)2. 

iliilnw  foramen 
nntidai  eri\l  (if  /lalate  hone 

inferior  tiirhinaled  bone 


Hg.  W'i. 


I     ':''. 


Incisive  eanal 


e^ 


Kl^ 


THE   BONES   OF   THE   SKTTI.I..  7Q 

The  ptcn-gopalatinc  canal,  proceeding  from  the  pterygopalatine  fossa,  is  formed  by  the  union 
of  the  pterygopalatine  grooves  of  the  pterygoid  process  and  of  the  palate  bone  and  maxillary 
lx)ne;  it  gives  otT  tine  canaliculi  which  pass  to  the  nasal  cavity,  and  finally  subdivides  into  a 
number  of  canals  which  terminate  in  the  palatine  foramina. 

THE  INFRATEMPORAL  FOSSA. 

The  injratemporal  (zyjiomalic)  j:'ssa  (Fig.  lo,:!)  has  only  a  partial  bony  boundary,  and  is 
directly  continuous  alwve  with  the  temi)oral  fossa  at  the  infratemi)oral  crct  of  the  greater  wing 
of  the  sphenoid  bone. 

It  is  situated  between  the  infratemjxiral  surface  of  the  greater  wing  of  the  sphenoid  bone, 
the  infratem])oral  surface  and  tuberosity  of  the  maxilla,  and  the  externa!  i)late  of  the  pterygoid 
process.     It  has  no  external  or  posterior  boundary. 


The  Sutures  of  the  Skull. 

The  sutures  of  the  skull  are  subdivided  into  the  long  sutures  of  tlie  cranial  vertex  and  the 
short  sutures  between  the  remaining  cranial  bones.     The  long  sutures  are  named  according  to 
their  shape,  the  shorter  ones  according  to  the  bones  which  they  sei)arate.     Several  separate 
sutures  are  freiiucntly  grouped  together  and  named  as  a  single  suture;   for  exam]>le,  tiie  fronto 
ethmoidal  suture. 

The  coronal  siilinr  (Figs.  37  to  40)  is  situated  between  the  ])arietal  margins  of  the  frontal 
and  tlie  frontal  margins  of  the  parietal  bones. 

The  siitiilliil  'Uturv  (Figs.  45  and  46)  is  situated  between  the  sagittal  margins  of  the  two 
parietal  Ixmes. 

The  lambdoid  sitttiri'  (Figs.  ,v).  4°,  45,  :iri<l  4(>)  i^  situated  between  the  occipital  margins  of 
tile  ])arietal  Ixmes  and  the  lambdoid  margin  of  the  (xcipital. 

The  siiiKimostu  siiturr  (Figs.  39  and  40)  is  situated  l)etween  the  sfiuamous  margin  of  the 
parietal  Ixme  and  the  parietal  margin  of  the  squamous  ])ortion  of  tii(  temporal. 

The  oca pilomasloiil  sulitir  (Figs,  y)  and  40)  is  situated  between  tl'.e  (Kcijiital  margin  of  the 
mastoid  portion  of  the  temi)oral  bone  and  the  mastoid  margin  of  the  s(|uamous  portion  of  tlie 
occijiital.     It  fre(iuently  contains  the  mastoid  foramen. 

riie  Ixiricloimisloid  siitiin  (Figs.  V)  and  40)  is  situated  between  the  mastoid  angle  of  the 
parietal  bone  and  the  ])arictal  notcli  and  a  part  of  tlie  mastoi<l  jiortion  of  tiie  temi)oral 
lK)ne. 

The  sphnw parietal  suture  (Figs.  ;,()  and  40)  i>  situated  i)etween  the  siilicncidal  angle  of  the 
])arietal  bone  and  the  parietal  angle  of  the  sphenoid  inine. 

The  spluitojrontal  suture  (Figs.  v>  ^'n'l  4°)  '^  situated  between  the  frontal  margins  ol  tiie 
greater  and  lesser  wings  of  tiie  sphenoid  bone  and  the  orbital  portion  of  the  frontal  \xmv. 

The  spiioi.'oihiiai  ^u!Uiy  io  siuiatcd  between  the  anterior  m.irgin  of  the  external  ^nrfao'  of 
the  l)()dy  of  the  sphenoid  bone  and  the  orbital  pr(K  ess  of  the  palate  bone. 

The  sphnirllimoidJ  suture  is  situated  lietween  the  crest  of  the  sphenoid  bone  and  the 
l)OStcrit)r  margin  of  the  perpendi(  ular  jjlaU'  of  the  ethmoid. 


i  y-: 

i    H 


So 


ATIAS    AND   TKXT-BOOK    OF   HUMAN    ANATOMY. 


I>       ' 


The  .\/)liciwsquamosiil  suture  (Fi)»s.  .^g  and  40)  is  situated  between  the  squamous  margin 
of  the  greater  winj'  of  the  sphenoid  Ixine  and  the  s])iienoidal  margin  of  the  temporal  bone. 

The  jrouUnlhmoidal  suture  (Figs,  j?;,  },f>,  4,^,  and  44)  is  situated  between  the  inner  margin 
of  the  orbital  portion  of  the  frontal  lx)ne  (the  outer  margin  of  the  ethmoidal  noteh)  and  the 
outer  margin  of  the  cribriform  plate  of  the  ethmoid,  Ix'tween  the  posterior  margin  of  the  nasal 
portion  of  the  frontal  Ijone  and  the  anterir  •  margin  of  the  cribriform  plate  (joramoi  rrrnim), 
and  also  iKtween  the  upi)er  margin  of  th  ■  lai  .  ])ap\Tacea  of  the  ethmoid  and  the  inner  margin 
of  the  orbital  [wrtion  of  the  frontal  Itone.  1  tie  latter  portion  of  the  suture  i.s  in  the  inner  wall 
of  the  orbit  and  frequently  contains  the  etlimoidal  foramina  (Fig.  (/)). 

The  nasDJroiital  suture  (Figs.  ,57  and  38)  is  situated  between  the  nasid  jxirtiim  of  the  frontal 
bone  and  the  upper  margin  of  the  nasal  Ixine. 

The  intcrnasol  suture  (Figs.  37  and  38)  is  situated  between  the  inner  margins  of  the  two 
nasal  Ixincs. 

The  jroiitoiiHixillary  suture  (Figs.  37,  38,  and  95)  is  situated  Ix'tween  the  nasal  portion  of  the 
frontal  ix)ne  and  the  frontal  process  of  the  maxilla. 

The  jrontdaelirymal  suture  (I-'igs.  37  and  38)  is  siti'ated  Ix'tween  the  orbital  ])ortion  of 
the  frontal  1-H)ne  and  the  u])per  margin  of  the  lachr>mal  bme. 

The  zvgomatieojronlal  suture  (P'igs.  37  to  40)  is  situated  between  the  frontos])henoidal 
process  of  liie  zygomatic  bone  and  the  zygomatic  (external  angulrr)  process  of  the  frontal. 

The  splunwzyi^^omatk  suture  (Figs.  39  and  40)  is  situated  between  the  zygomatic  margin 
of  the  greater  wing  of  the  sphenoid  and  the  zygomatic  lx)ne. 

The  zygonmtieolem poral  suture  (Figs.  39  to  42)  is  situated  between  the  tem]>oral  process  of 
the  zygomatic  bone  and  the  zygomatic  process  of  the  temporal  Ixme. 

The  zy fiomatkomaxilUiry  suture  (Figs.  37  and  38)  is  situatetl  Ixtween  the  zygomatic  bone 
and  th.  zygomatic  pnxxss  of  the  maxilla. 

The  nasomaxillary  suture  (Figs.  37  and  38)  is  situated  between  the  frontal  process  of  the 
maxilla  and  the  outer  margin  of  the  nasal  bone. 

The  etiimoideomaxillary  suture  is  situated  at  the  junction  of  the  inner  wall  with  the  floor  of 
the  orbit  and  separates  the  lower  margins  of  the  lamina  papyracea  of  the  etlinioitl  lx)ne  from  the 
orbital  surface  of  the  body  of  the  maxilla. 

The  laclirymoconclml  suture  is  situated  Ix-tween  the  lachrymal  process  of  the  inferior  tur- 
binated lx)ne  (concha  nasalis  inferior)  and  the  lachrymal  Ix)  le. 

The  laehrymomaxillary  suture  (Figs.  31)  and  40)  is  situated  in  the  inner  wall  of  the  orbit 
between  the  lachrymal  margin  of  the  maxilla  and  the  r.nterior  (and  inferior)  margin  of  the 
lachrymal  lx)ne. 

The  huhrymoethmoidal  suture  is  situate*!  in  the  inner  wall  of  the  orbit  Ixtween  the  lachr\mal 
lx)nc  and  the  lamina  papyracea  of  the  ethmoid. 

The  intermaxillary  suture  (Figs.  37  and  38)  is  situated  Ix-tween  the  alveolar  i)rocesscs  of 
the  two  maxilUe. 

The  palatomaxillary  suture,  in  the  floor  of  the  orbit,  is  situated  Ix'tween  the  posterior  margin 
of  the  orbital  surface  of  the  maxilla  and  the  orbital  process  of  the  palate  twne. 

The   palatuelhmoidat  suture  is  situated    immediately  alongside  of   the   preceding   suture 


n 


THE    ROXF.S    OK    TIIK    SKUM.. 


8t 


betwc.,,1  th.  iMsttrior  extremity  of  the  lamina  papyraca  ot  thr  .thmoid  an.l  thr  orl.i.al  pro- 
cess  of  the  ]>alati-  lK)ne.  ' 

The  media,,  palati„e  suture  (Figs.  4,,  4,,  and  ,00)  traverse.,  the  hard  palate  in  the  median 
hne. 

Th^lrcisversr  pahthie  s,U„re  (Figs.  41,  ,2,  and  100)  is  sitnate,!  Ix'tween  the  palatine  pnx  • 
c.s.ses  of  the  maxilhe  and  the  horizontal  j)ortions  of  the  palate  IxMies. 

The  following  sutures  an-  inconstant:  the  wjraorbilal  ,„l„re  (see  pag.'  r/,),  the  „ie,sive 
suture  (see  page  6()),  the  t>elrosq,ta,„osal  suture  (see  j.age  51),  the  sq,ia,ru,so„uisto,d  s,Uure  ,see 
page  5,)  the  sphe„o„,axillary  ,v«/«r,.  (between  the  pterygoid  process  ami  the  IxkIv  of  the  max- 
illa), the  jro„lal  or  ,„etopic  suture  (see  ])age  60),  ami  the  sutura  me,idos„  (see  page^/) 

I  he  petrooecipital  and  sphe„op,'trosal  jissures  are  filled  uith  librotarlilage  (jetrooccipilal 
and  sphenopetrosal  sy,u:lu>ndroses  *). 


The  Skull  of  the  New-born. 

The  skull  of  the  new-born  (Figs.  .0410  ,of.)  differs  in  manv  respects  from  that  of  adult 
hfe  (sc^  he  development  of  the  indivi.lual  l)ones  of  the  skull).  Th^  verti.  al  plate  of  the  occipital 
bone  s^fll  exh.btts  the  sutura  ,„e„dosa  (l.^igs.  ,05  an<l  .c/„  an.l  ,.  separated  from  the  lateral  por 
.on.s  by  the  posteru,r  „Uraoceipital  sy„eho„dros,s:  the  late.al  portions  are  sc-parate,l  from  th. 
basilar  portton  by  the  anterior  i„traorcipital  sy„cl,o„dros,s.  The  two  hahes  of  the  Ixxlv  of  the. 
sphenoid  are  st.ll  separated  by  the  i„terspl,e,ui.lal  sy,ulu,ndr„sis  and  the  splu,woccipUal  vv«- 
chond, osis  separates  the  .sphenoid  from  the  occipital  lx)nc. 

In  the  tem,K,ral  lx,ne  may  Ik-  observed  the  ty,npa„ie  a,„tulus,  one  of  the  most  strikin.^  forma- 
tions of  the  skull  of  childh.xxJ.and  also  the  sq,uv,.oso„.,.to,d  suture,  whici,  still  completelv  sepa- 
rates the  squamous  an<l  the  petrous  (together  with  the.  mastoid)  portions.  The  two'halves 
of  the  frontal  l^,ne  are  separated  !,y  the  jrnutal  suture,  an.l  t.,..  iueisive  suture  is  still  visibl..  in 
the  ma.x,lla  that  .s  to  .say,  in  the  har,l  palate.  The  maxiUa  an.l  the  mandible  are  still  ui 
d.  Teren  ly  shape.1    rom  the  a.lult  stru.  tures.  an.l  the  latter  lx,ne  exhibits  a  n.edian  sutu...      Th 

fiction  of  the  cranial  vault.     In  •!,.  lines  n,  the  sutures  there  are  more  or  less  narn.u   mem- 
branous  connecti.ms  of  the  ...,n,igu..us  Ix.ny  n.argins,  whi.h  f.>rm  large  spaces  partuular"    n 

or  lo,Uuul,,  and  s..x  of  them  may  1h>  recogni.e.l,  tw..  of  whic  h  are  single  an.l  t^a,  .loubk- 

..  Ih.  lro„ta/  or  anterior  fo„u,„elle  ,Fig.   ,05)  is  the  largest  of  all  an.)  is  .,ua,lrangular  in 
shape,  the  short  .l.agonal  being  situate.1  in  the  transverse  ami  the  k.ng  .liagonal  in  th..  ..n  t  1 

\.^^o  halves  of  the  frontal  Ix.ne  and  the  two  [.arietal  lx)nes. 

2.Th.-  oeripitnl  or  posterior  j„„ta„eii,    (Fig.   ,05.  i>  small  and  triangular,  an.l  is  situat.xl 
at    he  junct..,n  ..f  the  sagittal  ami  iantUloid  sutures,  between  the  two  pa...tal  l>,nes  an 
vertical  portion  of  the  occipital  Ix.ne. 


II 


lill 

5-i| 


*  Trui  syn.  li,„„lroses  ,xiM  in  ilio  skuil  only  iluring  rhildliood. 


82 


ATLAS    AND   TKX T-BOOK    OF    HUMAN    ANATOMY. 


Fig.  104.  "Skull  of  a  new-born  child  from  the  side  (]). 
Fio.  105— Skull  of  a  new-l.orn  rhild  from  above  (']). 
p,(.„  ,06. -Skull  of  a  new  born  child   from  behind  and 


.w(]). 


,  The  f.vo  sphenoidal  ]o,itancllrs  (Fig.  104)  are  of  medium  size,  irregular  m  lorm,  jKK.rl) 
defme.!,  and  situate.l  between  the  parietal  angles  ..f  the  greater  xvings  (.f  the  s,.heno.d  l..nes 
and  the  sphenoi.lal  angles  of  the  parietal  Ix.nes.  in  tlu'  location  of  the  later-.levelo,.e.l  sphmo- 
parictal  suluns  and  the  contiguous  bonv  margins.  ,        ,-    v, 

4  The  two  mastoid  jontancllcs  (Fig.  1061  are  situated  between  the  mastoul  angles  ot  the 
parietal  bones  and  the  parietal  notches  of  the  tcm,)oral  bones,  extending  outward  to  the  neigh- 
boring U,ny  margins.  They  resemble  the  antero-lateral  fontanelles  in  respect  to  their  si/.e, 
shai)c,  and  boundaries.  . 

Bv  thr  progressive  ossification  of  the  flat  bones  of  the  cranial  vault,  the-  lontanelles  bec.,nie 
closed 'in  the  t.rsl  vear  of  life,  rarelv  later,  the  frontal  fontanelle  closing  last  (at  the  end  of  the 
first  or  the  beginning  of  the  second  vcar).  .\t  the  same  time  the  coronal,  sagittal,  an.l  lambdoid 
sutures  develop,  whereby  small  lx)ny  areas  frequently  remain  as  independent  structures  within 
ihe  sutures,  and  are  known  as  supernumerary  hones,  Wormian  hones,  or  ossa  sulurarum.  They 
are  particularly  common  in  the  sagittal  and  lamlxloi.l  sutures,  where  they  are  sometimes 
j.rcscnt  in  large  numbers  and  are  occasionally  of  considerable  size. 


The  Skeleton  of  the  extremities. 

The  skeletons  of  the  upper  and  lower  extremities  are  more  or  less  similar.  They  are  com- 
posed of:  (I)  The  girdle  of  the  extremity,  and  (2)  the  free  extremity.  The  shoulder  gin  le 
is  com,x>sed  of  the  scapula  and  the  clavicle;  the  pelvic  girdle  of  the  two  pelvic  Ix.nes  The 
skeleton  of  each  free  extremitv  consists  of  a  proximal,  a  middle,  and  a  d.sta  segnunt,  these 
being  represented  in  the  upper  extremity  bv  the  bone  of  the  ann,  the  In.nes  of  tlie  toream.,  and 
,he  Ixmes  of  the  han.l,  an.l  in  the  lower  extremity  l)y  the  thigh-U.ne,  th..  rx.nes  of  the  leg,  and 
,he  U)nes  of  the  fcK.t.  The  skeleton  of  the  pn.ximal  segment  of  each  extremity  ^;oris,sts  ..f  a 
single  tenc:  in  the  up,K-r  extremity,  the  Innnerus;  in  the  lower  one,  ^h.  /enu.r.  The  muUlle 
segment  is  fonne.1  bv  two  bones:  the  radius  an<l  ulna  in  ,he  forearnv,  the  /,/».  and  lihula  m 
Ihe  k-  The  distal  se-rmcnts,  the  hand  and  the  f<K>t,  contain  a  number  of  Ix.nes,  those  o  the 
h-in.l  bc-ini'  sulxlivided  into  the  carpal  bones,  the  meUuarpol  b.n.s,  and  the.  phalanges  of  the 
fingers,  and  those  of  the  foot  into  the  tarsal  bones,  the  melatarsal  l...nes,  and  the  phalanges  ol 

jY^ ^,,,i.;...  .\.o  ...ntain  a  number  of  sesamoid  bones;  tiiey  occur  in  the  u])iier  ex- 
tremity only  in  ti-'  hand;  in  the  lower  extremity  they  are  to  be  foun<l  both  in  the  foot  an.l  also 
in  the  region  i.f  the  knee  (the  knee-caj)  or  patella). 


/  nuiltii  I    ■  nfiiii 


Sphnioid  (I'nlantUi 


liiT.   104. 


I  lOlltil/  /<";f,/,'/,-Yi- 


I  Vlliptllili'  illllilllll> 


iM.nil  l\n:-      .\\u-.:,>,.l 

!hMti<"l  I'fhl       fi^inn'IfUt' 

I'/  i'(<7-  I'llth 

futuj  ^TOh/ 


I'll) :i  till   I'llliilillt 


I  )tripital  ti'itlanrHi 


Siitiirn   ruiiilo--ii 


{II 


Oi'ii/iiliil  jouliiiiiiif 


llVlllill    ^Ill/Ill 


Si/iiiiiinnis  porlioii 
i^f  luripitiil 


I'lirieliil 
tiniiuiiir     . 


Siimrn 

•nrnilosd 

Mastoid 

foiUiindh- 

t  itlciiil  /'>'rr!'"/ 


I'/    /(  IHI>0!lll 


ot  li'itl!h'nll 


Miinhriiiiii 
lYIUpillll 


liiti-nuil  p'l  'vvvitl  pliili 

I'll/nil'   Ih'tli 


I  1,'llllli    foillilllllli 


I  till  J  piildtt 
()'■  iitri-'iMitti 


Sii'^illiil  \iiliiir 
^■.piiinii'ii-  p,<rliiiii  ■>!  OitipiUil 


I'iiT.  mo. 


Ihlipitlll       ':l>ltllllli/l- 


^mm^m. 


1 


ri 


t  ? 


'ik 


THE  SKELETON  OF  THE  UPPER  EXTREMITY.  g, 

THE  SKELETON  OF  THE  UPPER  EXTREMITY. 
The  Shoulder  Girdle. 

Unlike  the  pelvic  girdle,  the  shoulder  girdle  is  n„t  completelv  closed,  but  remains  open 
posteriorly,  ,ts  posterior  constituent,  the  scapttla,  having  no  direct  or  indirect  .onneciion  with 
the  c<,rresponding  lx>ne  of  the  opposite  side,  while  the  anterior  skeletal  portion.,  the  clavicle. 
close  the  shoukler  girdle  anteriorly  by  their  connection  with  the  manubrium  sierni.  IJoth  con- 
stituents of  the  shoulder  girdle  articulate  with  each  other,  and  the  free  upper  extremity  articu- 
lates with  the  scajjula. 

THE  SCAPULA. 

The  shoulder-blade  or  scapula  (Figs.  107  to  no)  is  a  dcridcdlv  flat  bone  which  is  verv 
thm  m  places  and  exhibits  several  marke.l  processes.  It  articulates  onlv  with  the  clavicle  and 
the  humerus;  otherwise  it  is  completely  free  and  the  sur- 
face resting  against  the  ribs  i-,  sei.arated  from  them  bv  the 
intervening  muscles.  It  is  triangular  in  form,  and  there 
may  c()n.sef]uently  be  recognized  in  it  three  sides,  three 
angles,  and  two  surfaces.  According  lo  the  i)osition  ,)f 
the  scapula  when  the  arm  lies  close  to  the  side  of  the 
body,  the  three  angles  are  designati'd  as  the  inkrnal 
(superior)  mi^lv,  the  iujcrior  mti^l,;  an<l  the  external  aiif^lc. 
The  margins  are  the  iitlernal  or  vertebral  (Ixtween  the  in- 
ternal and  inferior  angles),  the  ■superior  flutween  the  in- 
ternal and  external  angles),  and  xW  exlerual  or  avi/lary 
(between  the  external  and  inferior  angles).     The  anterior 

surface,  directed  tow. ml  the  ribs,  is  iirmetj  the  eoslal  sur- 

jace,  and  the  |>osterior  one  the  dorsal  surjace. 

The  costal  siirjace  (Fig.  io(,i  is  rel.uivily  smcM.th  and 

somewhat  concave,  the  shallow  deprosion  King  termed 

the  suhua pillar  jossa,  from  the  subscai)ular  mus<  I,-  which 

arises  from  i,s  surfa.v.     Several  rough  lines,  the  line.r  n.useulares,  .on,me,ue  al  the  vertebral 

margin  and  pass  outward  almost  transversely  across  the  surface. 

The  .lorsal  surja.e  ,Fig.  1081  is  rough;  and  is  suUlivide.l'into  two  portions  bv  a  marked 

roughenc.l  ndge.  the  spine,  which  commences  at  the  upp.T  half  of  ,1,,.  v.rtebral  margin  as  a 

'iMlten,.!   pn.j.etion  and  g.a.lually  Incomes  mor..  elevated  as  it   passes  out.ar.l.     The  small 

upper  area  „  known  as  the  supraspinatons  jns.n  (Fig.   ,071.  ami  the  larger  lower  one  as  the 

injraspnuuous  jossa;    Ix.th  of  these  names  Uing  .lerive.l  from  the  muscles  .0  which  the  fossx- 

givi-  origin. 

'rill-    Vi-flihr.tl   /i^iw//..*   .,(    »U..  ......I.     ,-,1  ,    _^ I      i_        »  t 

..  ...r      n..r...r  ..)  ,.,.    -,,,j,,j.,  ,.,],„  ,(.„„„,  ,}-^   ^,_.^,  ,  ^^  ^^^^,   ^^.^^.^j^.  straight,  but  pre- 

sents ..  slight  angle  at  the  origin  of  the  spine.    The  upper  ami  lower  portions  of  the  U.rder  are 
thickened;  the  middle  portion  is  thin. 


Flo.    107.— Thr   tlcrMl    Mjrf.iir    .if   iln     I,  ft 
Si  a|)ti!,i. 


I 


«.^s«i^Lm-. 


84 


ATLAS    AND   TEXT  HOOK    OF   HUMAN    ANATOMY. 

Fig.  108.— The  dorsal  surface  of  the  left  scapula  (J). 

Fig.  109.— The    costal   surface   of   the    left   scapula    (J). 

Fig.  no.— The  left  scapula  seen  from  the  outer  angle  and  axillary  border  (J). 

Fic.   III.— The  left  clavicle  seen  from  below   (§). 

Fig.   112.— The  left  clavicle  seen  from  above  (§). 


L    1- 


This  iH.rdcr  receives  the  ins..rtion  of  ihf  sorralus  .iw.Rnu  .  :  is.le.  whid,  also  .-xten.ls  outwar.l  up<m  tin-  costal 
surface  in  the  Wdnity  of  ihe  su,Krior  an.l  inferior  angles,  so  tha  the  >oslal  surface  presents  two  shallow  tr.angular  arras 
for  the  attachment  of  muscles,  in  ailditioii  to  the  subscapular  fossa 

The  supfrior  border  presents  a  notch,  the  scapu!ar  nolcli  iFios.  108  and  109),  which  may 
be  either  deep  or  shallow,  and  to  the  outer  side  of  this  there  projects  from  the  superior  margin 
a  .strong,  curved,  hook  like  i)rocess,  the  coracoid  prorrss  (Fig.  io()).  This  arises  by  a  broad 
base  between  the  scapular  notch  and  the  outer  angle,  and  is  at  first  di.ectcd  ui)ward  and  .omc- 
what  forward;  it  then  becomes  narrower,  makes  a  distinct  turn,  and  passes  forward  and  out- 
ward to  end  in  a  roughened  a])e.x. 

Tile  uxillary  border  (Fig.  no),  so  called  Ix-cause  it  is  directed  toward  the  axilla,  is  slightly 
thickened  ami  roughened,  particularly  toward  the  external  angle.  .\  furrow  separates  this 
elevated  Ijorder  from  the  anterior  surface  of  the  lK)nc. 

The  inUrnal  anisic  is  eit'-.r  a  right  or  an  obtuse  angle;  the  injirior  one  is  acute  with  a  mark- 
edly rounded  apex.  .Vt  the  external  anj^k  is  situated  the  so  called  head  of  the  scapula,  whi.  h 
l)resen'^  the  articular  surface  for  the  head  of  the  humerus,  the  t^lenoid  envily  (Fig.  no),  which 
•■     m(M)th,  slightly  concave,  and  shaped  like  a  pear  v  Jih  the  apex  upward. 

.\lx)ve  the  glenoid  lavity  is  a  small  surface,  llie  supraj^lenoidnl  tuberosity  (Fig.  no),  which 
gives  origin  to  the  narrow  ctird-likc  tendon  of  the  long  heatl  of  the  hi.eps,  and  tx'low  the  cavity 
there  is  a  larger,  markedly  rougiuned  surface,  the  iujroi^leiwid.il  tiiberosily,  which  giv -s  origin 
to  the  broad  strong  tendon  of  the  tri(Ti)s.  The  hea.l  of  ihe  scapula  is  sejiarate.l  from  the 
remainder  of  the  \xmr  l)y  a  slight  ( onstriclion  calleil  the  "<(/■. 

The  .-'pine  of  the  scapula  (Fig.  108)  arises  by  a  iiroad  base  from  the  dorsal  surface  In-tween 
the  sui)raspinalous  and  infraspiiuitous  fossa',  and  gradually  becomes  higher  as  it  passes  from 
the  vertebral  iH)r(ler  to  liie  net  k  of  the  Inme.  It  i)as.sts  over  the  neck,  overhangs  the  glenoid 
cavity  from  aiM)ve  and  beiiinti.  and  terminates  in  a  strong,  broa.l,  llattened  process,  the  aeromion. 
Internal  to  its  apex,  the  airomion  presents  an  elongated,  Hat,  articular  surface  for  the  attach- 
ment of  tile  airomial  end  of  the  ilaviile. 


The  s...pula  is  pretorn,.-,!  ,„  ,  artiU*-  .luring  I,  lal  iif.-.  'l-hc  hr.l  .  ci.l,  i  of  ossifi.ation  apiK-ars  it.  the  ihir.l  month 
of  embrvoni.  life  m  the  reKion  of  the  ne,  k.  but  os^lIm  .ilioi.  pr.«e.sl,  ,o  ,lowlv  that  iarff-  areas  are  stiil  .  artihiKinous  in 
the  „e«-l».rn  1  >urinK  the  lirst  ve.ir  of  hfe  an  in.lei-n.l.  nt  center  api^ars  in  the  .oracoi.l  pr.H  ess,*  from  whi.  h  i-  forme.i 
the  Knater  |«.riion  ..f  this  pr..j.-.tion  .\l  the  aRe  of  pulK-riv  s|k-,  iai  .piphysi-al  centers  make  th.-ir  apin-aran.e,  in  the 
a|..  ,  aT..|  th.-  base  ..f  the  .oraM.i.1  priness,  in  ih.   .i.r..mi..r.  lusuallv  several  .enlen.),  in  Ihe  base  ..f  the  siapula.  in  the 

inlirior  anRle,  in  Ihe  Rlenoui  lossa  lusuaiiy  s.iti..'»iiai  iaietj.  ^ .ii h.  tii'  iinrgin  t;f  ihr -,p;nr  '-f  ilir  ^.  Aj.iik,  ^mi 

(even  earlier,  in  Ih.   I. mh  yearl  in  th.'  .Mernal  anRle  ..f  th.-  »■  .ipula  in  th.'  r.-Rion  ..f  the  ori«in  of  Ih.-  bi.eps  lemltin. 
•  In  reptili  .,  l.ir.K.  ..nil  ili.  lomst  mammalia  th.-  lor.i.oiil  pro,  es.s  is  an  iinlepen.lcn!  bom-. 


Inltrmi!  tiiii;lr 


Scapular  iiatrh 

Sii/iriicr 
('oraroid  /j/vcc^.s  honl,r 


f/!/.   lOS. 


S/i/fir 


1  iTlrhnil 
I'oritir 


Infiiii'r  iiiii;!i 


Siih^ia/iiiltir  /('sm; 
hiliriiid  aiw/t 


/'.>ri/t»-  Siufnilaf 


\,rlil'nii  Iwnlri       \     .V 


/  htfiii'  i:iil<<iiliiii\ 


.\ii,iiiiii>il         Ai titular  s."»/i/ir  lU  luranihiii 
(A'nnv/il 


(il(7iiiiil  (i/i-.'/c 


1  Ki'ltirv  lu'iilrr 


/>■-•.  10>K 


lalii-'in   aiii;,' 


rn 


mm^ 


"TM: 


#.^:i 


'Mr. 


A 


■s 


■si* 

I 

^  it 


i  1 


J  t 


■  ■i 


|!         I 


III 


r  ' 


^n. 


THE   SKKI.F.TON   OF   THE   IPPER    EXTREMITY. 


85 


'"'  '^:scapu.ar  n....h  is  son^U.nes  .„.v..ea  int„  a  foramen  l,y  a  bri-ige  of  osseous  >issue. 

THE  CLAVICLE. 

The  ..,.,v/,  ,Fi„,.  o.  a.,,  o,ns  .n  s-»i.»H -'.^1" '7-;^-^';;;r:::j:r:;;:^^^^ 
™:^r:- t^j:;:^:.;^::;*  r;r =:::  c::::u: -  .^^». > 

a„,n,ial  cn,l  i,  da..™™!  a„,l  ""»'- ;'"  ™*:,i,t  V,       ,L  .h.  ...r lavi.nlar  a„i™. 

;^:r:;r::::™:;:;"":»"™s»i«:""  ...v.™»r.. .-  .»- 

an.l  also  a  small  smooth  articular  fact  for  conncct.on  ..ih  the  acromu.n  ^^^^  ^^^^^^^^^  ^^  ^^ 

TH..  .lavU.  is  ,...for„,.l  in  .  anila.-.     T>,.-  ,.un  ;;;';:-;;;-:'^:;:r, :';!:!;,     o,.v  .H.  sU.n.U  ,.,.  „os- 

:;r  :r:;,:trr  :^;::t\;:;i;':::;;:;:;i-;^^ ..„. .... . ... ..... .... 

THE  SKELETON  OF  THE  FREE  UPPER  EXTREMITY. 

THE  HUMERUS. 

.r-       , ,  MO  ,  ,6)  is  ■.  tvnical  Ion.,  hone,     h  is  composcvl  of  a  Inn;.  mi.l.lK- 
Tho  luimmis  (Imrs.  n;,  to  nO)  is  a  up  ;,„Vr/<'r  cMa-mitii>. 

-r;:,;!r:::r:::;;:^r;::r:';:::i:;':!::. ^ - "•""■■' 

''''"""'■  ,  ,     ,     .luu.ll.rf..,  lh^in..•r^,..„s,,(..■Mll.r.I-|'i"^>l"- 

„.i«    ,,,    ,,,infras,,in.>tu.  iH,,  - .  ,.  -M.  an.l  „r,-..nno    <l  '^    '^•-     '"-^^^    ..,  .^  „„.,,  „  „„  ,  ;,r„la,,  .    th-  --".Ion  of  ,..,• 
t  J,s,a,ular  L.s.  1.     T.,,.  u,,,.,  M-u..n  of  „„.  ■"'-"«         -«^'       J^„„„  ,„  „  ,,iv..r,i.  uUun  of  „„   .  a,,.,!-  ■  f 
;;:n,,u.a.lof  .,■  l,i...,.srunsin.h.-  gnH-vv  an.l  .  a,.ompan»,l  .n  ...  n,. 
rW  shoulilrr-joint  _  !      •  !     ! 

.u.,o. ,..  tui. .  ...s.  a,  th.  junction  of  th.  u,..  ...mitv  an-i  >- ■  ;;;^;; ;-;;; ;;;;;::::, 

,i,,uc,  «hi.h  sul.s..,,u.n,ly  «ra.l«all.v  a.su,  .-s  .,  .haraCr  of  ,.u,   .  .TUlaK 


86 


ATLAS    AND   TEXT-BOOK    OF   HITMAN    ANATOMY. 

Fig.  IIS-— The  left  humerus  seen  from  behind  (J). 

Fir,.  1 14.— The  left  humerus  seen  from  in  front  (i). 

Fig.  115.— The  head  of  the  left  humerus  leen  from  above  (4). 

Fig.  116.— The  lower  end  of  the  left  humerus  seen  from  below  (i). 


diminution  in  the  thickness  of  the  lx)ne.  forming  what  is  called  the  surgical  neck,  because  the 
humerus  is  easily  broken  in  this  situation. 

The  upper  jwrtion  of  the  shaft  of  the  humerus  is  almost  cylindrical,  while  the  lower  |)ortion 
is  ijrismatic  and  flattened. 

Passing  downward  from  either  tulxTosity  uj)on  the  ui>pcr  portion  of  the  shaft  there  is  a  rough 
ridge;  one  is  the  gmilcr  luberciilar  (bicipital)  ridge,  which  gives  insertion  to  the  ])ectoralis  major 
muscle,  and  the  other  the  lesser  tubercular  (bicipital)  ridge,  into  which  the  latissimus  dorsi  and 
teres  major  muscles  arc  inserted.  The  intertubercular  (bicipital)  groove  is  continued  down- 
ward between  these  ridges  for  a  short  distance  and  they  form  its  lips  (Fig.  114)- 

Below  the  greater  tubercular  ridge  uyKin  the  outer  and  posterior  jmrtion  of  the  shaft  there 
is  a  large,  Hat,  roughened  surface,  the  deltoid  tuberosity  (Fig.  114),  for  the  insertion  of  the  deltoid 
muscle,  and  at  atxnit  the  middle  of  the  shaft  and  upon  its  inner  aspect  there  is  a  roughening, 
which  is  rarelv  distinct,  for  the  insertion  of  the  coracobrachialis  muscle.  Near  this  rough  surface 
there  is  a  large  nutrient  foramen  (Fig.  114)  which  leads  downward  into  the  lx.ne  as  the  nutrient 

canal. 

In  the  lower  half  of  the  .shaft  three  surfaces,  an  antero-interual,  an  aiitero-external,  and  a 
posterior,  can  Ix'  recognized.  The  two  anterior  surfaces  are  separated  from  each  other  by  a  Hat 
elevation  and  from  the  posterior  one  by  the  shaq)  ex'.erml  and  internal  borders  of  the  Iwne  (Fig. 
114).  The  external  border  commences  Ixlow  the  deUoid  tulxrosiiy  and  is  sejjarated  from  it 
by  a  shaUow  groove  jor  the  radial  (musculospiral)  nenr  (Fig.  114).  It  is  sometimes  termed  the 
musculospiral  groove,  an<l  gives  attacliment  by  its  margins  to  the  outer  and  inner  heads  of  the 
triceps  muscle.  It  pursues  a  spiral  course  alx)ut  the  middle  of  the  humerus,  passing  from  above 
downward  and  from  within  outward  and  gradually  disiipixaring  Ixlow. 

The  lower  i>ortion  of  the  shaft  becomes  llatter  and  broader,  and  its  lateral  Ixirders  nm 
downward  to  terminate  in  two  rough  projections  whitli  are  known  as  epieondyles  (Fig.  116), 
the  sharj)  outer  iH)rder  passing  to  the  small  exttrnal  epieondyle  an<l  the  inner  one  to  the  more 
])n)minent  internal  epieondyle.  The  posterior  surface  of  the  internal  e])i(ondyle  presents  a 
shallow  griKive  for  the  idnar  nerve. 

Iklow  the  epieondyles  is  situated  the  lower  articular  surface  of  the  liumerus  (Fig.  i  if'>  which 
articulates  with  the  Ixtnes  of  the  forearm.  Tln>  articular  surface  ])resents  a  separate  area  for 
each  lx)ne,  a  large  trochlea  with  a  median  gnxne  being  situated  inlernallv  for  the  idna  and  a 
smaller  hemispherical  mpituliiin  externallv  for  the  radius.  .•\lx)ve  the  trochlea  and  upon  liie 
anlero-interna!  surface  ;i  the  level  of  the  ejiicondyle  there  is  a  moderately  deep  dejiression.  which 
is  known  as  ihc  coronoid  /dwc/  (Fig.  114)  becau>e  it  accommodates  the  coronoid  process  01  the 
ulna  when  the  arm  i^  lle.xed,  and  alx)ve  the  capilulum,  upon  the  lower  portion  of  the  aniero- 


$i^ 


hJ^^^ 


(jmitir  tii/ifirlr     "4^ 
Upper 
extremitv 


m  n 


Haid 


Hmd 


f      ^-i 


Aniitoiiiiiii/  III! I; 


Siinrmil  inrh  /  csscr  liibarlc 


IftTrtllll'iiriiiiir  i,v.'.'lf 

(jmilii  tiihcirh' 


w  \ 


l.csstr  liihrmi/iir  //(/i.'V       x-% 


(iinitrr  tiilnrathir 
rids^c 


Shaft 


(innn'i'  for  nidial  iicnw 


Niilriiiit 
fonimm 


f  n 


'I  n 


Ddloid  liilitnic 


m 


tiiT.     Ill 


f%r.    114. 


1 


Lower 
extre- 
mity 

t  \ii  null 
t'lvivndylf 


I  nirhiiti 


Intd'tiilhiriiliii 

ai'OOVf  1  ^ 

AiKitiiiiiinil  ' 

turl; 


(iri'iilif 
lii/'cic/r 


l't>stfii<>r  siirhiir 

liitrnnil  hordir 

Aiiliiv-iiili'niiil  ••iiifiuc 
C.onuioid  I'ossii 

O/ccniih'ii  I'ossd  ,  , 

Inti'niiil 

Intiiiiiil  cpiiviidylc 

rpi(Viidy/i' 


(iiV''vr  for 
ii/iiiii  iiirvc 


I  (\^(r  tii/iiii/i 


I  ivihiiii 


I  yirnid/         \/ 

ininiiidvlc         1    jc.. 3 


//../,/ 


('<l/lillllllHI 


ii,i^.  in. 


I  \t(rinil  bordir 

A/ilin'-cxtmiiil 
'•iirfdiT 


Rddia!  fossil 

I  \tiriHil 
ifiroNily/i' 


(ii/iiliiliiiii 


hilriiuil 
iihinr  mivf 


livrli/ni 


//;'.  IK). 


I  i 


mL^£.\ 


Jfe-^ 


4.'^:-^ 


THE   SKELETON   OF  THE   UPPER   EXTREMITY. 

external  surface,  is  the  much  smaller  ami  shallower  radial  jossa  (Fig.  114)  for  the  hea.l  of  the 
a  Ur    Oppo  ite  to  these  two  foss.  upon  the  lower  portion  of  the  postcr.or  surface  ,s  suuate. 
Tbroa.!  cleq'  depression,  the  olnrano,.  lossa  (Fi,.   n.,.,  ^vhich  accomn.Klates  the  olecranon 
when  the  arm  is  extended. 

fron,  tw.,  .,r  more  epiphyseal  centers.  The  ..iaphyseal  '-';;;';'•;,;;,  '^  J,  ta.:i'ha,.,,Uen  follow  .hose  for 
,i,aginou.s  a,  hir.h.  During  .he  f.rs.  year  a  cen.er  ^'M''---  J^  ^  ^ /^  *^;,;,  h,  ,  .n.l  separate  centers  for  each 
the  capitulun,,  the  greater  tulK-rcle,  the  lesser  tulH-rcle,  an,l  tmal  y  J'  ^  ^^  ^         ,,,  ^^„    J^^  „f  .^^  ,„,„,  ,„,,  ^he 

epicon.Me  which    appear  between  tW  tenth  a..  <-  ^^;-;     ^J  ^     ^  i^o.^ur  t^nil  fron,  the  twentieth  to 

disappearan.e  of  the  synchondroses  iK-tween  the  epiphyses  an.l  the  diapiiN  . 

the  twenty-second  year.  ,i,:„  _-  ,,.,,„t  in.l  sometimes  even  perforatid      The 

Between  the  olecranon  an.l  c.,n,noid  lossa- the  humerus  ,s  -  "^'"^ ^     ^i       ^"^  ^  tlev.rs  and  pronators  of 
epicondvles  serve  as  points  of  muscular  origin,  th.-  ,nter„al  one  «■;■"';'«;  .X'     'ner  N.r.ler  of   he  hunvr^ 

the  forearm,  the  external  one  to  the  superf.cial  extensors.     .M«,ve  the   n    r  a,  M -    "-^^    '  ^,^_^.^,,^ 

occasionally  presents  a  second  pr.K-ess.  ktjown  as  the  -'^--"J' ;'  ''X:  ^,,,„  ,  ."".^  ,  ,,,  ,.H,h  is  interrupted  only 
lower  than  d.K-s  the  external  portion,  and  ,ts  sur  ace  represents  an  ^^J^r^^^^^  ^  ^„„,,.^^,^^,  ,„,,,,„„.  and 

by  the  thin  bony  plate  between  the  coronotd  and  olecranon  fossa,-.     The  cap.tulum       1 
is  scarcely  visible  from  Iw-hind: 

THE  ULNA. 
The  ulna  (Figs.  ,17  to  no)  is  a  three-si.led  prismatic  long  tone  which  is  thick  alx,ve  ami 
quite  small  Ix-bw.     It  is  composed  of  a  shaft  and  of  a  superior  and  an  inferior  extremitv      The 
s  rong  upper  exlrcmilv  presents  a  semilunar  or  .greater  sigmoid  mU  h  (F.gs.  ,  .7,  no,  and  ,-4), 
which  articulates  with  the  trochlea  of  the  humerus  an.l  is  cons.riCen  ,n  .ts  mul.lle.     Is  anterior 
portion  rests  upon  the  upper  surface  of  the  coronoid  Process  (F.g.  uy),  a  broa.l  beakd  kc  pr.. 
ection  .lirecte.1  anteriorlv.  an.l  its  posterior  portion  rests  upon  the  anterior  stirfac,    of  a  v  n 
trong  bonv  process,  th-  olecranon,  which  forms  the  tip  of  the  ellx.w  ami  projects  ,,uUe  a  distamt^ 
alK.ve  the  cor.noid  process.     The  external  or  radial  si.le  of  ihe  proximal  exlremUy    ..he  ulna 
presents  a  notch,  the  radial  or  lesser  sigmoid  noteh  (Fig.  i  .6).  for  the  hea.l  of  the  radui.,  and 
passing  downwa,,!  from  this  eavily  there  is  a  rough  longitu.linal  ri.lge.  ,\..  supinator  ../,M    ig. 
117).     Immetlialelv  below    he  coronoi.l  process  is  situaie.l  a  broad   roughened  area  whuh  is 
directed  anteriorly,  an.l  is  termed  the  tuberosity  (Fig.   iiy). 

The  olecranon  receives  the  in.-rtion  of  the  large  triceps  ntuscle,  the  extensor  of,.,.,  foreavn.  an.Mhc  su,,ina^.r 
ridge  gives  origin  f,  the  grc-a„-r  p.rtion  of  the  supinator  brevis  muscle.  The  bra.  htaUs  .,nn,  us  ,nu.s.  K-  ,s  >ns,  r„  d  tnto 
riulH-rosity  an.l  the  coronoid  process  also  gives  crigin  to  por-ions  of  several  of  the  n,us,  le-  ^  -  the  forcarn,. 

The  ^ha'it  of  th-  lK,ne  IxTomes  much  ihinner  ami  more  rounded  towar.l  iN  lower  extremity 
so  that  while  the  tn.ne  resembles  a  three-sided  prism  in  its  upper  i-ortiun,  ,t  becomes  cylindnra 
in  its  lower  fourth.  In  the  shaft  mav  Ik-  reognized  an  anterior  volar,  a  posterior  or  dorsal  ami 
an  internal  or  ulnar  surjace.  The  inlernal  surjace  is  separated  from  the  posterior  t.tie  by  the 
dorsal  border,  antl  from  the  anterior  on,  bv  the  volar  border.  The  third  l.nnhr  ,s  ^-^^V ^^'^^ 
is  directed  tt)war.i  the  ra.lius;  it  seiuiraies  liie  anteiiui  liuiu  th>  j.-'-stcrKn  Mtif-:-.-.-  .:nd  •'-<•••'"' 
the  interosseou  rid^r  (Fig.  1.9).  The  volar  surjaee  contains  th-  nutrient  joramen,  trom  which 
a  nutrient  eanal  passes  towanl  the  ell^.w  within  the  tx.ne,  b>  otherwise  the  surface  cdiibits  no 
peculiarities. 


88 


ATLA      A.M.    Tior-I^OOK      .p    hUMAX    ,'U\AT0M\  . 


Fig. 

117. 

-The 

Fig. 

iiS. 

-The 

I'IG. 

119. 

-The 

Fir.. 

121. 

~  The 

Fic. 

122. 

-The 

Fic. 

'2.V- 

-The 

Fk;. 

I  -M.- 

-The 

Fi(,. 

I2v- 

-The 

'§). 


left  ulna  seen  inr.^  uic  >   i((  ;•  ..urf;i(( 

left  ulna  seen  fr,,m  Jjchi.M  J) 

left  ulna  seen  fr'  m  in  front  if). 

left  radius  seen  from  in  front  (jjj. 

ii'ft  radius  seen  from  the  inner  side  f^). 

left  radius  seen    rom  liehind  (J). 

upper  extremines  of  the  radius  and  ulna  seen  from  .hove  and  somewhat  in  ,r„nt  r- 

lower  extremities  of  the  radius   .nd  ulna  seen  from  below  (| ,.  ' 


. 


I 


-    f 


n 


■i».ai  »,rf,„ ,.,  ,h,  „„i,„,„„,  ,,,„„  ,H,  „„„„  ,;„„„,;„„„  ^„,  ,^,,  ,;;„■',  v;';;;;;';,,,; " 

THE  RADIUS. 

The  r«rf/«.  (Fij,s.  ,_  .  to  135)  is  the  outer  of  ih.  two  bones  of  the  for.ami 
to  the  ulna,  U  ,s  narrow  and  thin  above  ami  broad  and  thick  below 

h.snp.norcM/y  Fi.  ,241  i^  forn  .,1  bv  the  di. -like  /;,-„/  of  ,1„ 
constriction  bel-.v  the  head  bein.  designated  as  the  .,r^,  whi,  h  potion  of  ,he' ,.. 


■  in  '  on;: 

xmi .  ,!   distin' 
<    s  e\  iindrii 


dortal  bonit 


dortrl  hordtr. 


I-"IC^    \20. 


volar  border    ^° 

ulna 

-Iransv.-D-L  >cilii.ii  i '-rough  I 


'f  the  t-'n-arri!,  t.i 


■■'  till-  mi 


io//t~  Itordtr 


•  I'-dr; 


The  upper  surface  of  the  hea.l  exhibits  a  de.  -essed  irt^ 
humerus,  and  the  upper  .  ;:rumfere,ue  ui  nv  .nannn  01 
ciimjirniti-  (Fi^.    uj,. 

Below  the  neek  the  upj..  r  p„r;,un  of  ti:.    x,l,r  surfa 
projection,  the /»/)-rw//v  (Kiir:-.       ..   ■  • -■    ■.,^.,1   t -. .     f„    -. 

The  shaft  of  the  radius,  lik  ihat  of  ,,  ,-  ulna,'is'l!liap..d  like 
three  surface,  are  arran,e,l  in  a  ,in.ilar  mann,-  .,  that  volar  ,/, 
volar  .xna  dor.,  hordrr.    .M  :m  inur.  sana  rid,,  .  .av  b.  re     ^niVed 


sur; 
he 

resi-n!- 


i|)ltl 


(/;■//( . 


(he 


ouirh,  marked 

i»s  nniscle. 

prism,  and  the 

.  r<i/  .s»r/(7rc.v,  and 

The  interosseous 


l^}^ 


.  ,f 


()/,>      IlltVl 


in  front  (]). 


Its  ladial 
iif)).  anrl  a 
119).  The 
artilugi'. 

i'hysc.-,  ;„ar 
I.-.  iMci  jit.rs 
Thin    ,.  .,i 


in  ■  (jnii 

.i   distini  I 
-■v  iindrii 


ihv 

£H 

/>- 

,  niaikcxl 

IStlf. 

,  and 

the 

litres. 

and 

tnjsscoiis 

Siiiii/iiiii, 

110:     h 


Rinli.:: 
ili'fih 


Cii/'ilii/iini 


'^iipiiui'  '/• 


/ 


sill  •^iirtinr 


l)or\iil  !iOfii 
liift  mill  -^iiiti, 


Dorsal   -.iildi'i 


Si'iiildthtr 
'trii 


Sfy.'iHi!  pnnr-. 


iiv:i'!:t  ;■.•:■  1  • 


r 


III'.  117. 


/7'r.    IIS. 


II!'.    Il'l. 


: 


■ejtrS 


tinid 

S,Vl! 

I  ii/ifiosily 


Xiitnciit  /i'.iimnt 


Aiiiailiir  Hmd . 

cinuiiil'i-irinr 


I  iihnosilv 


Shaft 


1  'oliir  iiirfinr 


l.ntt-ivs^i\<ii^  ndi^i 


I  \trniiil  ■.iir/'dic 


l>,ir^ti!  siirliU( 


1  hhir  ihUi', 

Ciiya' 

iiifiiiiliir 

s  irhiif 

siylo 

■tl  /i/,iirs 

,s7i7ii/(/ 

liibnvsiiv  Ulna 

,1/  i,iiliii\ 


/V'l/'V 


Doisiil  Imrdir 


DiV-^iil  ^irltiir 


fit:  12  i 


//A'.  fJi 


(  Ill/Ill! 
iiintii/tir 
•■III  hill 


j  1 


UlnM  Radius 


aiF: 


I  if 

r  II 


u 


It^t 


h    i 


1 


THE  BONES  OF  THE  HAND.  89 

ridge  is  situated  opposite  to  the  similarly  nametl  ridge  of  the  ulna,  and  is  only  the  shaq)  margin 
possessed  by  the  radius,  the  two  remaining  margins  having  markedly  rounded  edges. 

The  three  surfaces  of  the  radius  exhibit  no  structure  of  particular  note,  except  that  the 
volar  surface  contains  the  nutrient  foramen,  the  nutrient  canal,  like  that  of  the  ulna,  passing  in 
a  ])roximal  direction  through  the  compact  substance  into  the  medullary  cavity. 

The  broad  inferior  extremity  (Fig.  125)  is  flattened,  so  that  a  volar  and  a  dorsal  surface  are 
distinctly  differentiated.  The  interosseous  ridge  terminates  below  in  a  slightly  excavated  surface, 
the  ulnar  or  sigmoid  notch  (Fig.  122),  which  articulates  with  the  capitulum  of  the  ulna.  Opposite 
to  this  surface^  upon  ihe  radial  side,  the  styloid  process  (Figs.  121,  12,;?,  and  125)  j.rojects  Ixyond 
the  Ijone;    it  li  broader  and  less  pointed  than  the  corresjwnding  pn)cess  of  the  ulna. 

The  volar  surface  of  the  inferior  extremity  (Fig.  121)  is  smooth  and  slightly  concave;  the 
dorsal  urface  is  traversed  by  ridges  (Fig.  12.^*)  which  separate  distinct  grooves  for  the  ten.lons 
of  the  extensor  muscles  of  the  hand  and  of  the  fingers,  a  particularly  deep  one  accommcxlating  the 
tendon  of  the  extensor  pollicis  longus  muscle. 

The  distal  or  carpal  articular  surface  is  directed  toward  the  carpal  bones;  it  is  concave  and 
usually  distinctly  suljdivided  into  two  facets  (Fig.  124),  by  means  of  which  the  radius  artic  ulates 
with  the  scaphoid  and  semilunar  Inmes. 

The  ra.liu>  is  simnwhnl  shorlir  than  lh>-  uhia  and  the  two  iK.ms  an-  s,>  nlattil  that  'he  ulna  pnijn  ts  ..msiikral.ly 
bcyon.l  the  pnixinial  cn.l  of  thf  railius  anil  the  ra.liu>  -vKn.ls  Ih'V.ihiI  the  iliMal  cvtrcmiiy  ..(  the  uln.i.      Hoth  1.,ti..  ,  ..■ 
(ur.c.l,  1.UI  in  an  upix)sili-  ilimtinn,  s"  tliai  th.-  ..in.anli.s  of  the  tw.i  l».ni-<  arc  .lir.-.tiil  tmv.inl  va.  h  hiIht      Thr  uln.i 
also  cxhilrils  a  siiuhl  |iir-.ion. 

In  supinalion  Ix'lh  'ooni-s  of  thr  foriann  arc-  par.ill.i  an<l  llu'  intiTos-i.-ou>  riilK's  an-  op|K>sitr  on.'  another  (  fiR 
1  JO);  in  pronation  the  Ix.nrs  are  .  rost.cl,  -inie  the  inferior  ,  xtremity  of  the  ra.liiiMlo«elher  with  the  han.l)  rotates  aU.ul 
the  ulna.  «hile  ih.-  h.  a.l  of  th,  ra<lius  routes  in  the  radial  not.  h  ..f  the  ulna.  In  a.Mition  lo  ih.ir  ,.rli.  ulalion,  «ill.  .  a,  h 
other,  the  ra.lius  arti.  ulates  with  th<-  humerus  an.l  ihe  .  arpal  l«mes.  hut  the  ulna  arli.  ulal.s  with  the  humeru-  ..nly 

The  <level..pnient  .,f  th.'  ra.lius  is  similar  to  that  of  th.-  ulna.  Th.-  .  .nler  f..r  th.-  iliaphvsis  appears  in  th.-  ihir.l 
r.-tal  m..nth,  while  th.-  nuelei  f..r  the  ,-piplns<s  .lo  n..t  ap|K..r  until  th.-  tifth  y.-ar,  th.-  up|K-r  epiphvMs  l„inK  .lev.-l..iK-.l 
fr..m  a  single.. -nter.  .\.  ..-ssory  nu.  l.-l  api>.-ar  still  later  in  the  tuUnle  an.l  in  the  styloi.l  pnKOss.  s  ..f  the  ra.lius.  Ossi- 
fi.  ati.in  is  n.it  ..»mpl>-l.  until  th.-  twenti.th  yen^. 


The  Bones  of  the  Hand, 
the  carpal  bones. 

The  eight  Ixmes  of  the  carpus  (Figv  ijO  to  i.^i)  arc  arrange.!  in  a  pnivinial  .iii.l  a  i!islal 
row.  I'a.-s.sing  fn>m  the  radial  lo  the  ulnar  side  llie  pro.vimal  row  (i>ntaiii^  the  iiavi'u!,..  or 
scaphoid  lM)ne,  the  lunate  or  sentihnu.r  \nmv,  the  triquetral  or  (Utuijorm  Ik)iu  ,  ami  in  i>isijorm 
)K)ne.  Passing  in  the  siime  dirt-cli.>n,  the  distal  row  i.-,  .()ni|W)sc.il  of  the  'greater  mullaiifiular 
lione  or  Iraptzium,  lesser  ntnllanfiuLir  Ume  or  the  trapezoid,  the  os  laptlatutn  or  os  magnum, 
and  the  hamate  or  uncijorm   lione. 

The  l)<)nes  of  the  pn>\imal  row  (reall>  the  lirst  three  only)  are  not  siliiated  in  a  straight 
line,  but  are  curved  .so  as  to  form  an  arch  niili  it  i-  ^ligiiiU  tonse'.  jiritKiniaiiy  an.i  markedly 
concave  distally  (Figs.  128  and  121/).  In  the  distal  row  the  capitalum  projects  markedly  lowanl 
the  jiniximal  row  and  is  accommcxlatt d  In  its  (opcavity. 


ti 


^•^^ 


Z,i^t 


90 


ATLAS    AND   TKXT-BOOK    OF    HUMAN    ANATOMY. 


Fig.  126.— The  lower  ends  of  the  bones  of  the  forearm,  and  the  carpal  and  metacarpal  hones  in  their 

natural  positions,  seen   from  the  dorsal  surface  (i). 
The-  preparalion  was  ma<lc  from  a  frozen  hand,  \vhiTi'l)y  ihi'  rilativc  |H>sition  i-.'  tlu  l)onis  loulil  !»•  pirKi  lly  (iiliTmined. 

Fig.  127. — The  same  prc|)aration  seen  from  the  volar  surface  (i). 

Fig.  128. — The  hones  of  the  left  hand  seen  from  the  dorsal  surface  (l). 

Fig.  :2g. — The   same   preparation   seen   from   t'e   volar   surface   (i). 

Fig.  1^0.  -Frozen  j)reparation  of  the  hones  of  the  left  hand,  together  with  the  lower  ends  of  the  radius 

and  ulna,  seen  from  the  dorsal  surface  {■). 
Fig.  i_y. — The   same   preparation   seen   from   the   volar   surfaie    (I). 


All  the  bones  are  irregularly  sha])ed  and  arc  difTicultof  description.  The  navicular  (scaph- 
oid) bone  is  cllijisoidal;  its  distal  surface  is  excavated,  and  the  radial  Ijorder  of  its  palmar 
surface  is  j)rovi(led  with  a  rough  tubercle  (Fig.  127).  The  lunate  (se...ilunar)  lx)ne  is  shaped 
like  a  half-moon,  the  triquetrum  fcuneiform)  resembles  a  short  three-sided  pyramid,  and  the 
])i:;if()rm  b<jne  is  irregularly  spherical.  The  greater  ara[)ezium)  and  lesser  multangular  (trape- 
zoid) bones  are  irregularly  cubical  and  the  [)almar  .surface  of  the  former  exhibits  an  elongatcxl 
flattened  elevation,  the  tiihcrcle  (Fig.  127).  The  capitatum  or  os  magnum  is  the  largest  lx)nc 
of  the  set,  and  its  length  is  much  greater  than  its  breadth;  its  i)ro.\imal  end  is  large  and  forms 
ihe  head  of  the  lx)ne,  which  is  co\ered  with  cartilage.  The  hamatum  (unciform )  is  also  large 
and  irregularly  wedgc-.shaptnl,  and  its  j)almar  surface  is  provided  with  a  tlat,  slightly  curvai 
process,  the  liumuliis  or  unrijorm  process  (Fig.   129). 

The  caq)al  tjones  do  not  lie  in  a  single  plane,  but  form  an  arch  which  is  convex  [wsteriorlv 
and  concave  anteriorly.  The  concavity  is  increased  by  the  two  bony  |)rominences  which  are 
situated  u|><>n  U)tli  the  radial  and  the  ulnar  sides  of  the  j)abiiar  surface  of  the  carpus  and  fomi 
the  carpul  i^romr.  The  radial  (aq)ai  eminence  (Figs.  127  and  1,^11  is  formed  !)y  the  lul)eriles 
of  the  navicular  and  greater  multangular  Ixmes;  the  ulnar  eminence,  by  the  jtisiform  bone  and 
the  hamulus  of  the  hamatum. 

The  small,  almost  splier'cal  j)isiform  Ixme  is  situated  only  in  the  palmar  surface  of  the  car])us; 
all  of  the  remaining  caqial  lx)nes  possess  a  roughened  dorvil  and  palmar  surface.  Hoth  surface: 
of  the  four  Ijories  situated  at  the  radial  and  ulnar  margins  of  the  caqjus,  the  navicular  (scaphoid)— 
greater  multangidar  (trai)cv,ium ),  tri(|uetnim  (cuneiform),  and  hamatum  (unciform)— are  con 
nccted  by  lateral,  radial  and  ulnar  surfaces  but  the  numerous  remaining  surfaces  (numernus 
on  account  of  the  irregular  shapes  of  the  iMmes)  are  smcxxh  articidar  facets  covered  w  iili  cartilage 
for  articulaticm  with  c.uh  other,  with  the  radius,  or  with  the  nielaiarpal  b.  nc  s. 

Th(  piriform  Ixini'  has  but  a  simple  articular  facet  for  c  onnec  tion  with  the  triijuetrum  (ciun  i 
fomi ),  but  all  of  the  remaining  carpal  Ixmes  have  several  .arlicvdar  surfaces.  The  most  imitoriatit 
of  these  are  the  following:  the  navicular  isca])hoicl)  and  lunate  (semilunar)  lK)nes  each  ]M)ssess 
a  i(in\c\  articular  surface  which  arlicidates  with  the  distal  end  of  the  radius;  the  lri(|uetrum 
i-  mil  connected  with  the  ulna,  however,  but  with  an  intervening  disc  of  c-arlila«e.  Of  the  ioints 
U'tween  the  proxim.il  and  the  distal  row  of  the  carpal  Ixnes,  the  most  important  is  that  Iwiween 
the  convex  surface  of  tlu  head  of  the  capitatum  and  the  concave  surfaces  of  the  lunate  and 
navicular   Ixincs. 


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THK   nONF.S   OF  THE   HAND. 


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The  greater  multangular  articulates  with  th.  Urst  metacarpal  lx,ne  by  a  , l.sl.nctly  sa.l.lle- 
shapll  sur^c^;  the  lesL  multangular  ,trape.,id)  articulau-s  with  the  see..n,l  the  cap.tatum 
(OS  magnum)  with  the  thinl,  and  the  hamatum  ,u,uif.,m,)  with  the  two  remammg  metacarpal 
btmes  (Figs.  126  and  127). 

,hc  luna.um  .se-milunar)  1k.,u,  for  the  n^'^'  "  •'  •    J  ^  ,.,„„ilunar)  a,„l  hamamm  (undforM,);  on  ih,-  Kr.-afr 

,nuUan«u,ar  ,.ra,„.iun,)    [''-^^^^X;:  mJ    ^   r  S-^i-i    i^-  the  a.i.u.ar  face.  indu,...  ..,.■  ^n-a.c.  ,.,r- 

r  r  rrir:;a;:tr  :rr;:=r:r^^  ^^  ^-^  •> ---  >-- 

truni,  anil  lunalf  lionc.  :,-...  f„  ,„,  smuli-  nnliT      In  llu-  i  aiiitatum  ami 

..„ll,f::,ri:;=  ::.;:tr:i:rr™::,;;::;:::.:'::;::i.  „ < ... »-  > 

in  the-  pisiform  not  unlM  ihc  twelfth  y.-ar  ..r  .  ^,  .     ,.t>  r.  . .      ,,.„,,„,  ,„„„   .^  ,„,r,i„n  of  llu-  skeleton  situated 

.tJr— ■:r::;;=:.r:;:>.J:;:;ri^^^ 

5;'  bl  is  dearly  re,,resentc;i.      In  the  a.lult  it  is  t.sualh  fused  with  the  nav.eular,  form.ng  Us  tulxrd, . 

THE  METACARPAL  BONES. 

The  five  mclacarpal  bones  (Fig.  ,.-6  to  .;,i)  an  typical  long  bones  in  which  may  be  recog- 
nizcci  a  proximal  extremity  or  base,  a  slu.jl,  and  a  distal  extremity  or  lna,L  Fhe  bases  art.cuate 
with  the  distal  row  of  carpal  bones,  the  hea.ls  with  the  proxmial  row  o  the  phalanges.  I  he 
metacarpal  lx,ne  of  the  thumb  is  the  shorlest.  .hat  of  the  index-f.nger  the  longest,  an.l  they  grad- 
iiillv  decrease  in  leni'th  toward  the  little  linger.  ,       ,    r       i 

-Tt^Ws  of  th:  metacarpal  l.>nes  are  irregularlv  cubical  and  thicker  than  the  shaft;  that 
of  the  metacarpal  Ix.ne  of  the  thumb  beavs  a  sa.Ulle  shaped  surface  for  arf.culat.on  w.th  the 
^.  tium,  an.  the  remaining  ones  present,  in  addition  to  the  ar.uular  a.e.s  .r  the  carpal 
Zes,  lateral  surfaces  for  articulation  with  each  other.  Th.  base  o.  the  dnrd  metacarpal  bone 
presents  a  styloid  process  (Fig.  128)  which  is  directetl  tt.ward  the  rathal  side. 

The  base  of  the  Hrst  nut.uarpal  t».ne  h,.    :.  single  anu  ui,.   surf,.e.    that  of  the  .e,,,nd  h,„  ihn  ,  ^  a  snuU  r.i,l,  d 

Zt.  a  radial  one  for  the  third,  and  an  ulnar  one  for  the  fdlh  ntetaearyal  bone;  and  ,he  '' ;;'>'''':'  7,  ' 
forearm. 

,     .      .       .  -.  -.    ,       ..•.•,.!...,..,,. .,t;.->n  <-.f  tlvi!  Mf  the  thumb,  is  appro.xi- 

The  shaft  ol  cam  metatarpai  IaHk.   .-un  ....   i  ..i.L|it..i..        .. 

matelv  three-si.led,  and  possesses  a  pnl,n.,r  and  a  .lorsal  bonUr  The  palmar  ^^^^^^^^^ 
flat  as  it  passes  towani  the  base,  while  the  dorsal  In.rder  w.dens  out  .nto  a  surface  as  U 
approaches  the  head. 


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92 


ATLAS    AND    TKXT-BOOK    f)F    HC.MA.V    ANATOMY. 


The  heads  of  ihe  bones  are  provided  w  ii'i  sphen\al  articular  surfaces,  and  their  sides  present 
depressions  which  >erve  for  the  attachment  of  li;^anunt>.  Their  hases  (will;  the  exception  of 
that  of  the  freely  movable  bone  of  the  thumb)  are  closely  ai)i)ro.\imated,  bu:  both  the  shafts 
and  the  hi  ads  are  separated  by  large  ini.  rspaccs  which  are  known  as  the  htterosscous  spaces 
(Figs.  12b  n<\  1271.  Hetween  the  heads  these  spaces  are  tilled  by  ligamentous  masses,  between 
the  shafts  b\  ^lu^cles. 

Xiii.rdinK  1.  .lie  t.i'.i'mcnts  (if  most  authors,  the  niitar.irpal  Ixmcs  (\i\.  lup  from  a  diapliysi'al  (enter  in  the  midcDe 
of  the  Ixme  and  from  an  ejiiphyseal  renter  in  the  head;  only  thi'  metacarpal  Ixine  of  the  thunil)  liilTering  in  that  its  epi- 
physeal O'nler  is  in  the  tiast'  Oeeasionally  the  third  metacarpal  has  a  separate  renter  for  its  stvloid  pnKiss.  The 
epiphyseal  centers  do  not  apix'ar  until  after  birth,  while  the  diapiiv-Mal  center  appears  very  early  (in  the  ninth  week) 
before  the  centers  in  tin  radiu,  .ind  in  the  ulna. 

THE  BONES  OF  THE  FINGERS. 

Each  finger  bus  three  l>jnes  or  phalanges,  but  the  thumb  has  but  two  (Figs.  128  to  131). 
These  are  designateti  as  the  j)roximal  or  first  j)halan.\,  the  middle  or  second  phalanx,  anfi  the 
distal,  terminal,  ungual  or  third  phalanx.  The  thumb  has  no  middle  phalanx.  The  phalanges 
diminish  in  length  a>  we  pass  towani  the  finger-tips,  so  that  the  terminal  jihalanges  are  the 
shortest,  and  the  longest  ])halanx  is  the  proximal  one  of  the  middle  finger. 

The  phalanges  are  long  txmes  com[K)sed  of  a  proximal  extremity  or  base,  of  a  sliajt,  and 
of  a  di.stal  extremity  or  Iroelilra.  The  bases  of  the  j)roximal  phalanges  have  concave  hemi- 
sjjherical  s(Kkcts  for  the  heads  of  the  metacaqial  Ixmes;  the  articular  surfaces  or  bases  of  the 
remaining  jihalanges  |)resent  a  double  concavity  sejjarated  by  a  metlian  elevation. 

The  shalls  of  the  phalanges  have  >har])  lateral  Ijorders,  and  their  dorsal  surfaces  are  con- 
vex, their  |)alniar  ones  ])lane  or  slightly  concave.  The  short  Ixxlies  of  the  ungual  jihalangcs 
terminate  in  a  rouL'li  horseshoe  ^ilaped  expansion,  the  uniiiial  tuberosity  (Fig.  1,^0).  The  distal 
extremities  of  the  jin.ximal  and  middle  phalanges  exhibit  small  fos.sa',  similar  to  those  u])on 
the  heads  of  the  melacariial  1joik>.  for  the  altachtmnt  of  ligaments,  and  tlii'  nutrient  canals 
run  towani  the  finger-ti])s,  in  an  opposite  direction  to  those  of  the  other  bones  of  the  extremity. 

The  jihalangc''  are  (leveloj..  d  like  the  nuta.  ari>al  bone  of  the  ihundi,  each  phalanx  luing  ossified  from  a  (enter  in  the 
shaft  and  from  an  t-piphyseal  (enter  in  the  proximal  extremity;  there  are  no  centers  for  the  viistal  ends.  The  proximal 
phalanx  ossifies  lirsl  (third  month)  and  then  follow  the  middle  and  the  terminal  phalanges. 

THE  SESAMOID  BONES. 

In  addition  to  the  lH)nes  jirevioush'  described,  the  hand  also  contains  a  \ar)'ing  number 
of  sesamoiil  bones.  Two  of  these  are  constantly  found  at  the  metacarpo]>halangeal  joint  of  the 
thimib,  and  occasionally  others  occur  at  the  simihir  joints  of  the  index  and  little  fingers,  but 
in  the  latter  situation  they  may  Ix'  replaced  by  fibro-cartilage.  In  the  thumb  they  are  usually 
covered  with  cartilage  ujion  one  side  and  are  connected  with  the  articulation.  There  is  also 
usually  a  sesamoid  Ixjne  at  the  interj)halangeal  joint  of  the  thumb. 

THE  SKELETON  OF  THE  HAND  AS  A  WHOLE. 

The  metacarpal  and  ])halangeal  Ixjnes  do  not  lie  in  one  ])lane,  hiil  form  a  curved  surface, 
convex  uj>on  the  dorsum  and  concave  in  the  palm;    in  the  metacarpal  region  this  curve  may 


.mmmnsim^mm^^m' 


THi:   SKKI-KTON   OF   THK    I.OWKR    KXTRF.mTY. 


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be.  consi,lc-rably  increas«l  or  diminished  by  th.  muscles  of  the  hand.      I  he  convex,  y  of  ,ho  <ior.a 
surfaces  reaches  i,s  highest  point  at  the  metacarpal  'K>ne  of  the  .ndex-lm^er  and    r<,m  th.s  pom 
deelin..  graduallv  toward  the  metacaqml  Ix.ne  of  the  little  lm«er  and  abruptly  towar.l  that 
of  the  thumb.      The  so-called  dor«U  surfaces  of  the  metacarpal  U,ne  and  ot  the  two  phalanges 
of  the  thumb  are  .llrected  externally  and  th.ir  lH>rders,  instead  ol  d.eir  surfaces,  are  conse.,uentlv 
din    te,i  toward  the  dorsum  of  the  hand.     The  -lorsal    .urface  of  -he  metacarpal  Ix.ne  of  the 

little  tin  XT  is  also  directed  somewhat  toward  the  ulii.ir  side. 

Wl-  le  the  inelacan)al  lx,ne  of  the  inde.x-tmger  i.  -In   longest,  the-  phalanges  of  the  middle 

nnge    .re  longer  than  those  of  the  index-fmger,  so  thai  the  middle  linger  is  the  longest  hnger. 

The  I .h:  es  of  the  ring-fmger  are  also  longer  than  those  of  the  mdcx-lmger. 

in  corr,  ^pondence  with  the  functions  of  the-  hand  as  a  prehensile  organ    the  hngers  are 

well  u    -loped  aa<l  take  up  almost  half  of  the  entire  length  of  the  hand.      1  he  length  of  the 

can:'us  1.     '  "out  onc-si.xth  of  the  entire  length  of  the  hand. 


THE  SKELETON  OF  THE  LOWER  EXTREMITY. 
The  Pelvic  Girdle. 

The  pehtc  girdle  consists  of  the  two  innominatr  boms  and  in  contrast  to  the  shoulder  girdle, 
which  is  closed  anteriorlv  onlv,  it  is  also  closed  posteriorly  by  the  articulation  of  the  mnommate 
bones  with  the  sacrum. '  The  connection  of  the  bones  of  the  pelvic  girdle  is  also  much  firmer 
than  that  of  the  Ixmes  of  the  shoulder-girdle.  Together  with  the  sacrum,  the  two  innominate 
bones  form  the  hony  pelvis. 

THE  INNOMINATE  BONE. 
The  inn.minale  or  coxal  hone  (Figs.  132  to  134)  is  :i  single  bone  in  the  aduU  only.  In 
the  new-born  and  until  the  age  of  puberty  (Figs,  i ' ",  and  i.^^')  it  consists  of  three  tones 
sc'parated  bv  cartil;  {svnchon.lroses)-the  iliuw,  the  jyuhis,  and  the  isrhuim.  .Ml  three 
bones  are  in  contact  in  the  acetabulum  and  unite  at  about  the  age  of  puberty  to  f^m  the 
innominate  bone.  The  portions  of  the  ilium,  pubis,  and  ischium  which  unite  in  the  aceta- 
bulum are  the  thickest  i,arts  of  tin  ir  respective  liones  and  are  designated  the  hodtcs. 

The  ilium  forms  the  iipjier  portion  of  the  innominate  Inine;  it  is  the  largest  of  the  three 
Iwncs  and  forms  the  upper  third  of   the  acetabulum.     It  consists  of  a  body  an<l  ol   an  uj.per 

jKirtion  or  ala.  .        . 

The  pMs  forms  the  anteroinferior  portion  of  the  innominate  Ixine  and  the  anteroinferior 
third  of  the  acetabulum.  It  is  separated  from  the  ischium  by  a  large  foramen,  the  obtnrnUw 
joramin,  except  at  the  inferior  boundan-  of  the  foramen,  where  it  is  attache.1  to  the  ischium 
by  a  synchondrosis  which  disappears  Ixfore  the  age  of  puberty.  It  is  composed  ot  a  body  and 
_f  jwo  rami.  Th<'  superior  ramus  ^Fil'  Mt^  ^orms  the  upper  lK)undar\-  of  the  obturator  fora- 
men, the  injerior  ramus,  the  anterior  one. 

The  ischium  forms  the  iKistero- inferior  ix)rtion  of  the  innominate  Ixnie,  the  ])ostero- 
inferior  third  of  the  acetabulum,  and  the  inferior  and  posterior   Ix.undary    of   the  obturator 


94 


IS         ! 

I?        t 


ATLAS    AND   TEXT-BOOK    OF   HUMAN    ANATOMY. 

Fio.  132.— The  right  innominate  bone  seen  from  the  outer  surface  (i). 
p,f!^  i33.-The  right  innominate  bone  seen  from  the  inner  surface  (i). 


forair.en.     It  is  composed  of  a  body  (Fig.  i.u)  and  of  two  ram,,  a  superwr  and  an  inlerwr 
ramus  which,  like  those  of  the  pubic  bone,  font,  Ix.undaries  of  the  obturator  foramen 

";  the  a.  ult  innominate  l.-ne  the  thickened  and  somewhat  const r.cted  port. on  o   the  bone 
u,K.n  whose  <,uter  surface  is  the  acetabulum,  gives  off  a  U,ny  plate,  the  ala  of  the  .hum    F.g. 
^r"  which  passes  upward  and  presents  an  external  convex  an.l  an  internal  concave  sur  ace. 
Hciow  and  in  front  of  the  acetabulum,  the  middle  portion  of  the  U,ne  sends  out  a  seeon.l  plate, 
which  is  „erforated  bv  the  •)bturaU.r  foramen  (rami  of  ihe  pubis  and  .sch.um  . 

rie'ala  of  the  ilium  (Fig.  1,7)  i^  shaped  like  the  horns  of  a  buck,  -t  -t  Uu^  t.ps  n 
the  ,.id,lle  it  is  fre.,uentlv  as  thin  as  paper.  Us  superior  marg.n  .s  markedly  th.ckened  and 
^:;  and  is  known  Is  the  en.,  of  the  ilium,  and  upon  this  crest  a.  "^-^;""^^  'r;;:;::^  ^ 
b.  'he  attachment  of  the  alxlominal  muscles.  They  a>e  most  .l.st.nct  .n  ,he  m.ddle  of  th  .1  ac 
crest  where  it  is  thickest  an.l  reache.,  its  greatest  height,  and  are  terme.l  the  cMer„J,  the 
intenwl.  ami  the  »»;</<//<•  //7>.v  of  the  crest  (Figs.  .,^^  and  .,U'-  .  .       ,_. 

Xna.riorlv  the  crest  of  the  ilium  end>  in  a  spine,  .he  aulrri.r  su!>,nor  sp.nc  (F.gs.  ,,.  U. 
,U)'  and  at  the  ..osterior  extremity  of  the  crest  there  is  another  less  pronounced  sp.ne,  x\u- ^os- 
X  superior  sli,.  ,Fig.  .,...     helow  the  posterior  superior  spine,  and  separate,!  from  .,  by 
a  shallow  notch    is  the  pos.rior  u,,r,or  spnu,  an.l  l.tow   ,h.s   tin;  l---;;.--^-  <;   ^ 
innominate   Ix.ne  presents  a  deep  paralx.loid  noUh,  .he  ,reat  saaUc  notch  ,l-,g.   ..,2,,  .ho 
Tpper  lx,un,lary  is' formed  by  .he  posterior  margin  ..f  the  ala,  and  .ts  antero  .n.er.or  one  b> 

ihe  Uxlies  of  the  ilium  and  isdiium.  ,,,■,•        ■      •■      .    1 

Below  the  an.erior  superior  spin.  a.  the  anterior  Ix.rder  of  the  Ixxly  of  .he  .hum  >s  s,.uated 

Uu.  Irior  inlrrior  .pin.-  \v^^.  ...  .0  „4>.     ^  i>  pla-i  a,  a  greater  <..s.ance   ..m  t  e  an  er.-r 

.u,,eri,.r  spine  than  .s  .he  po.teri..r  inferior  from  .he  p.,>ter,or  super,„r  one.  and  .s  s„ua,c,l  >m- 
media.elv  alx.ve  the  uj.per  and  anterior  margin  ol  .he  ace.alndum. 

T  ;e^.ernal  ..riue  of  .he  .,/.  of  .he  ilium  ,  Fig.  .,..  is  rough  and  convex    and  presen.s 
,hree  .ouuh  line^  which  indica...  .iu-  area,  of  origin  of  .h.    gkKeal  mt.de.      1  hese  h.ies  are 

'cM«nat.d  as  the  posterior  or  sup-rior,  the  ani.nor  or  nuMr.  an.l  .he  ,„/,n,>r  ulu.eal  l.nes. 
Th     ...... ,iur  giu..'d  line  i.  alm..s.   v..r.i,al    an,!  run^a.n.s   ,he  p..s,..rior  por..on  ..    th..  ala 

'f    h    ilium  .0',,..  upper  l.un.lary  .,f  .he  gr.-a,  .,a.i.   no,.h.  and  .he  .nal.  an.  -        u-     ,u  , 
•   .  .•  1'  .1      .....ii-iw  nil  V  eius  mu- .  !.•  ani    tun      ns  ikmii 

^^hi.h  i.   l-ninds  giv.-  nng:n  to  a  por.ion  nt  .l,r  glulau^  niaMiuis  mu 

"""•;•;;::;;::.,..„   .i,.  pa....  ...kwam  ,n  an  ar.,..,  n,am..r  f ,he  an,..ri„r  s..per,or 

..i...    i,  i.  a.  .,rM  almoM  h„ri.o„,al,  .hen  mark  ver.ieal.  a,i.l  .r..ls  near  ,h.    ..oen.-r  hn.    a 
,-!,;.  upper  n.arg,n  of  .iu  gr.a,  ..ia.u   f-ram.n.     The  ..rfa.e  of  .he  ala  .n.h,de.l  U.ween  ..  an.! 
the  superior  line  gi\...  ..rigin  ...  the  glut.,  u-  m.diu.  mus.  1...  ,    .  ,., 

The  inferior  lin..  ,-  .  •  Toi-lerabU  s.,.,r.er  .han  .he  an.eri..r  -me.  1.  ...nmum..-  lH..we..p.  .h. 
.„U.ri.,r  su,K.n.,r  and  a:  ..ri-.r  inferior  ,.ines  an.l  pa.-s..s  ba.kwar.l  ah...,  hor....,,.a  v  ab.,u^ 
,h..  a.e.abulum  to  the  middle  of  th.  great  .ciatU  foramen.     It  .s  but  ^hgh.ly  curv,,!  and  .>  ap, 


^         ill  flip  ill       ^Jili 


Il     I 


!  ■ 


|l| 


THE   SKELETON    OF   THE    I.OWES    EXTKKMITY. 


O'i 


to  Ix'  ihc  least  distinrt  of  the  thri-c  lines.     The  surface  included  Ixtween  it  and  the  anterior 
gluteal  line  )<iMS  oriijin  to  the  fjluta'us  minimus. 

The  inner  surface  of  the  ala  (Fij,'.  i^i,)  is  composed  of  two  portions,  of  whii  h  the  larjjer 
anterior  one  is  ^iii,'hlly  e\ca valid  and  is  known  as  the  iliiK  jossii,  while  tht'  posterior  one  is  uneven 
and  is  furdier  ^,ulxlivided  into  two  areas,  an  antero  inferior  one,  the  (iiirjaihir  siirjua  (Fi^.  i.Vs'- 
for  articuUiiion  with  the  similarly  named  surface  of  \\h-  sacrum,  and  a  i)ostero  sui)erior  .xtrenielv 
rough  one,  the  liihrr.tsily  c/  Ihc  ilium  fFig.  i  iSN  "'I't'i  (<>rresi)onds  with  the  >iniilarly  name<i 
surface  of  the  >;Krum.  At  the  Ixirder  of  the  auricular  surface  there  is  a  distinct  gr(K)ve  known 
as  the  fiaraf^Unoiilal  !iro(Ki  i  Fig.  i.^,',i. 

The  iliac  jossa,  th(  middle  of  whiih  i>  fre'|uently  as  thin  as  paper,*  i>  sei)arated  from  the 
remaining  iKirtions  of  tlie  innominate  Inme  (the  IkkK  of  tiie  ilium,  the  juihis,  ami  the  is(  hium  I  l>y 
a  line  which  is  continued  ui>on  the  jiubi-  and  is  known  a-,  the  .iniuili-  liiir  ( Fii;.  i;;i.  I  hi> 
line  forms  a  jiortion  of  the  divi.ling  line  ix'tween  the  true  an.l  tiie  false  pel\i^  the  Irrmiiui!  ulio^ 
prrtininl)  liiif,  and  is  con>e(|uently  also  known  a>  the  ili.r.-  jiortion  of  the  terminal  line. 

The  body  oj  III,-  ilium  forms  the  upi-er  portion  of  tlie  adtalnilum  (see  jiai^e  o'n  and  a  por 
ti(m  of  the  ooundary   of  the  great  siialic  notdi.     It  i>  dinttly  (ontinuou^,  jiariit  uiarly  upon 
its  inner  surface,  with  the  ala  of  the  ilium  alH)vc,  and  in  the  adult  with  the  lx)dies  of  the  pubis 
and  isf  hiimi  Ik'Iow. 

The  pubic  bone  is  intimately  connecte<l  by  its  Ixxly  with  tlu'  ilium  and  with  the  ischium, 
and  form>  a  portion  of  tlie  acetabulum  (see  ])age  ()6!.  .\t  the  juiK  lion  of  tiie  Inxlie-  of  ilu-  pubis 
and  ilium  then-  i>  a  low  rounde<i  elevation,  the  iliopr, linnil  rmimiin-  (I'i.u.  r  v^'.  "hi.  Ii  l«  longs 
to  iKilh  Ixines  in  llie  ailult  after  the  ossification  of  the  s\  ni  hondloM-. 

Passing  downward  anil  forward  from  the  Uxly  of  the  pubic  Ixnie  i-  tin  approximately 
three  sideil  superior  ntmus  (Fig.  i;,;>.  "'i>''i  '^  praitiially  hori/oiiial,  an<i  forms  the  upper 
lK)undar\  of  the  obturator  Coram,  n.  Its  anterior  .Air.inity,  whi. '.  al>o  gi\c>  origin  to  the 
inferior  ramus,  iiresenls  an  oblong  surface,  tii.'  \vm/>/;y,N/.v  (Fig.  i.^;i,for  arli.  idation  willi  the 
Um*  of  the  op|K»ile  side,  and  tht  anterior  surface  is  directed  forward  and  oiiluard,  ih.  iiilc nor 
one  inward  and  I'orw.ird,  and  the  iiostcrior  one  tow, ird  ilu  inti  rior  of  the  \»'.\\-.  I  he  upper 
l)order  presents  a  sharp  edge,  the  <r,si  of  th.  pubis  iFig.  i,^s'-  ^^1''' ''  represents  tlie  .  oiitinu.it  ion 
of  the  ariu.ile-  line  of  the  ilium  and  is  the-  pubic  portion  of  th.  iliopei  tineal  line.  1  h.  .  r.  si  t.  r 
minales  ,int.  riorb  m  .1  small  proj.-.  ti.^n  situated  alKuu  a  Imgetbte.t.lth  from  die  s,inpli\si,  .ui.l 
known  as  the /i//'(n/,  or  e/)/»e  of  liie  pul)i>  (Figs.  l.;-'an.l  i,U  ■ 

At  the-  juneiion  of  the  superi.ir  ramus  with  llu'  IhmIv  of  ilu    p. ibis  ilie  p.ist.  rior  or  |«l\ie 
surface  of  the  I  Mine  presents  :i  broa.l  sl,,ill,,u  gr.H.vc,  tin  ohiiir.ilor  aroov,  ^  I'ii;.  1  ;ji,  wIihIi  ^ra.lii 
.illy  fades  away  .is  it   jiasMs  inwar.l  upon  lii.    interior  surfa.i-  l.iwar.l  the  ,,|ilur,it.a   loranien. 
1  he  sharp  ridge  which  forms  the  inner  iHHindary  of  the'  gr<M.\e-  is  '.nowii  as  the  ,<l<lur,iU>r  riilf;r 

(Fig.  i.^n. 

The  obturator  gnwiv.  is  usuallv  Iwiiin.le.l  in  front  ami  IhI.iw  by  a  jinMis,  diricied  |..wai.l 
thecibtiirai.ir  foramen,  the  anlmor  obiur,ili>r  liilurn,  il'ii;.  1  ;<i,  ami  a  jK.-ti-rior  iK.umlarv  i-.  some- 
limes  furnished  bv  u  p,isltri»r  obturator  liih'  r,l,-,  win.  h  arises  from  th.  i-  liium  .iinl  is  .ilse,  .lin  e  t.  .1 


'  Simirtimis  llier.'  i~  .1  (•■ramin  in  tin-  snu.ilMm 


96 


ATI.AS    AND   TEXT-BOOK    OF   HUMAN   ANATOMY. 


Fig.  1.^4.— The  rifjlit  innominate  bone  -^Tn  from  in  front  (J). 

Fir.    r.jj.  -The  rishl  innominate  l»,ne  <^  ,  (,.,    or  six-vear-ol,!  .  hiki  seen   from  the  ^nner  surficc  '  ■ ) 

rio.  I  {().      /lie  same  seen  from  llie  outer  surfa      ''; 


toward  the  obturator  forannn.     Bd.Min  these  two  lulxTcles  is  .strct.  iv.ri  the  upper  manrjn  of 
the  ojjtiirator  menibrnne  (see  ])age  129). 

The  injrrinr  ramus  of  the  pui.is  is  Hatter  an.l  i-ossesses  but  two  surfaces,  an  anterior  and 
a  posterior  or  pdvic  surjar, .  It  pas.ses  obli<|uely  downward  -..m]  outwani  from  the  symphysis 
an.l  i>  ronnerted  with  ihe  inferior  ramus  of  the  ischium  at  the  site  of  a  slight  eonstri.tiun. 

The  ischium  is  shaped  \er)  nnich  hke  the  pubis,  and  in  the  adult  its  fxxlv  is  intiiiialelv 
connected  with  those  of  the  ilium  and  pubis.  It  f,,rms  the  antero  inferi.,r  Ixnindai^-  of  the 
^rcat  saatir  noUh.  and  in  this  situation  j.resc'nts  a  shaq)  triangular  projection,  the  spiw  iPi- 
132).  Hilow  the  si)ine  i>  ;,ituated  the  hssvr  snatic  nolch,  whi.  h  is  not  .so  deep  as  th,-  ^rreatiT 
one  an<l  is  forme.1  entirely  by  the  ischium,  its  inferior  lx)un<larv  Ining  furnished  bv  th(  1  irge 
rough  tuberosity  of  the  ischium  (Fig.  ,32),  which  forms  the  main  portion  of  the  outer  surfice 
of  the  superior  ramus.  From  the  tuIxTosity,  the  thin  flat  inferior  ramus  pa.s.s<.s  for^var<l  ,an.l 
upwanl  (iMg.  i;,4).  forming  almo.st  a  right  angle  with  xhv  .superior  ramus  of  the  ischium  To 
gcther  with  the  inferior  ramus  of  the  pubis,  it  forms  the  lower  lK>undar\-  of  the  oi.tunor  foramen 
The  acetabulum  (Fig.  ,.,2)  is  formal  by  the  Ixxlies  of  th..  ilium,  pubis,  and  ischium  but 
dividing  lines  Ixtween  its  component  portions  are  visible  in  vouthful  individuals  onlv  It  is 
a  hemis,,hencal  cavity  with  elevatt.l  margins  l.K.king  directlv  outward,  an.l  onlv  theanterior 
inferior  |H.rlion  of  the  margin  toward  the  obturator  foramen  is  incomplete;  this  gap  is  known 
as  the  tiiilahuliir  or  cotyloid  iiotrli. 

The  ll(«.r  of  th,.  acetabulum  is  cominrsed  of  two  dilTerentlv  shainnl  i>orlion>.  'Ilie  larger 
portion,  the  srmil,n„ir  surjace  (Fig.  ,32).  is  sm.K.ih  and  covere.1  with  cartilage;  it  forms  the 
upper  and  lateral  portions  of  the  cavity  and  eMen.ls  downwar.l  to  the  U>rders  of  the  cotyloid 
notch.  Ihe  remaining  .|ua<lrale  area  ...mmenc.s  at  the  lx)nlers  of  the  ac.tabular  not.h-  it 
:-  rough  and  uneven  and  is  known  as  the  .intdbiihir  jossii. 

The  obturator  foramen  (Fig.  ,.,4)  is  a  large  ..pening.  the  shap<.  of  which  is  subject  lo 
considerable  individual  vari.ition;  it  mav  Ix'  either  oval  or  triangular,  ii,  long.-st  diameter  Uirg 
transverse,  in  some  cases  and  vertical  in  others.  Its  JK.rders  are  t..mied  bv  the  r.mii  of  the 
-s.  hium  and  of  the  pubi,,  and  are  for  the  most  par-  sharp,  being  Hat  onlv  where  llu-  ob.ur.itor 
groo\c'  runs  into  the-  foramen. 

«n.l  .n.    or    h.   |.u1.k       I  I„   ,  ...mr  f„r  tl,.-  ,l,um   ,|,,K..rv  (n  .1,.-  ,,nr„rn,...t  ,:.r„|.,«.   ,„  „„■  u«in„i„K  .,(  ,1..  „,i,.|  f.,  .1 
momh     .,:.    U,r  ,  c  .,  h.u ,..  ,H.,inni„K  ..f  -h.   fourth  „...mI,, h...  for  .....  ,.  ,„  I  ftf.h  ,„o  .„  ,     , 

i".  :x;;'  •  v",;""r""'-.;  ' "" '"  ""■  '""-•  '"•  "''"■"'^"^-  ••'  -"^ '- '""-  -"  "■•■  ^!-'- '-' "-  -  -'-^  " 

ZuZm!"]   "  T '"" '"'  ""■  '""'''^ "" ' ■'  ""'"^"'"^  "-"■''  ^-'^  '■•'--'■  ^"  '"••  — h '"  .i«h, 

*o.,.u  of  .,..,,.1  „u.nno„    u,      o,„.  a'      •  ..„•  ..„,..■  ,  „.,,  of  ,!,..  ...un,,  o,,.-  ,„  „„.  ,uU.r..i,v  of  th.   ,  ,  hi.,,,,   .,n,.  i„  Z 


in  of 


r  ami 

>llVS!S 


.15. 


1 ' 

tn 

h 

1 

i 

! 

1 

THE   SKELETON   OF   THE   LOWER   EXTREMITY. 


r:;t .,:::;  ;t':::,:;::::  "'r  :;;;;;*:rr-,  .,* ,... ...  ,..„. ,., -n  -■  -  -• - 

to  the  twenty -ftllh  year. 


The  pc-lvis  as  a  whole  is  considered  upon  page  130. 


THE  SKELETON  OF  THE  FREE  LOWER  EXTREMITY. 
THE  FEMUR. 

The  Innur  (Fi.s.  :,-  to  uO  is  the  lar.es.  l,n,  bone  of  the  human  1h.1v,  and   consists  of 
a  sut»ru'r  cx,rn„i!y,  a  ./,«//,  and  an  inirri,.r  ..Irr^.y  __^     . ^^^^^^  ^  ^^_^^,^ 

Ix'low  and   to  the  inner  side  of  ine  niuKlit    11  i„.   1,1     • 

.,„  „l,li,,u..lv  ,n,n,-a..,l  cylin.Ur,  .1,.  sui^Ti,,,  l..r,l,r  l.ms  »!-"•    "  '     '     '  "  ;    ^      ,     „,„„., 
„„,,     Th,    „«.r  «m-milv  „(  111.'  I«.n,,  M  il,o  marpn  ,.l  .1...  n,.,k.  | a. •..■..«  i»"  lar...    u.  n, 

uni.      1  ni     ii^nr  t.Miwiii,  -iiiii  hill,  ni  ol  nanuroii.^  mux  U>. 

The  LT-,.'-  /r,.. //<;»/.  r  is  amsi.leral.lv  larger  than  ihe  K.s>er  one  and  ,.  M.uaud  cxU  n.tllv ,      n   m 
rV^    :  ..    .r  ponion  of  the  superior  ex.reniily  of  ihe  fenu.r.     1-^    h.hli.  curvt-tl  ='I-,     '     ^ 

;,:„„,„,;..,,    .hi.h   ;..  ...nip..sed   uf    uw  di.in.l    l>p.   .n   .H„r    :,nd    an    ,.M    . 
";;;,,;;,       ,„U,:middU  „f,h..  >..,„.„   ,:„,.,.. U  appn.MmaUd,ln,nl,ven.., nd   i>..n, 


.  in  111.  (.m;,le  the  :.nRle  .MM'^'       ''■  '  ••  "K>"  """'■                                               ,                    ,          ,,    ,,  ,.,  ,,„    „„„ 
,    The  intent- l„ n --  ..-^  ■.■  u-i ,.■  ...  ,e--..t  ,„.,.,, t,.,u,  „. -  .-..:.,. 

the  im,  a  asjura 


i,!...f 


98 


ATLAS   AND   TEXT-BOOK    OF   HUMAN   ANATOMY. 

Fig.  137. — The  riRht  femur  seen  from  behind  (f). 

Fig.  138. — The  right  femur  seen  from  the  inner  .>;urface  (%). 

139. — The  right  femur  seen  from  in  front  (J). 

140. — The  ujjper  end  of  the  right  femur  seen  from  behind  (J). 

141. — The  lower  end  of  the  right  femur  seen  from  below  (J). 
Fig.   142. — The  patella  seen  from  in  front  (}). 
Fig.  143. — The  patella  seen  from  behind  (|). 


Fig. 

Fig. 
Fig. 


the  upper  and  the  lower  extremity  of  the  bone,  passing  toward  the  trochanters  above  and  to  the 
epicondylcs  below. 

The  outer  li{)  of  the  linea  aspera  passes  upward  to  a  long  broad  elevation,  the  f^luteal  luhcr- 
nsity*  (Fig.  140),  which  is  usually  tlat  but  markedly  roughened,  and  receives  the  greater  fwrtion 
of  the  insertion  of  the  gluta-us  ma.ximus  muscle.  The  intem.al  lip  becomes  less  distinct  as  it 
jiasscs  u])ward  and  is  continuous  with  the  intertrochanteric  line.  Parallel  to  the  ui)per  part 
of  the  inner  lij)  and  somewhat  to  the  outer  side  of  it  is  situated  a  second  rough  line,  the  pectineal 
line  (Fig.  140),  for  the  insertion  of  the  pectineus  mu.scle. 

Toward  the  lower  extremity  of  the  femur  the  two  lips  of  the  linea  aspera  gradually  diverge 
and  fomi  the  lx)un(laries  of  an  almost  plane  triangular  area'ui)on  the  [xjsterior  surface  of  tho 
l)one,  the  fx^pliteal  surjtue  (Fig.  157).  Upon  the  line,  above  its  middle,  there  are  usually  one  or 
more  nutriint  foramina  which  lead  into  canals  jjursuing  a  dis'inct  upward  (proximal)  directi(m. 

The  sliajt  ol  the  femur  exhibits  a  distinct  curvature,  which  is  convex  anteriorl\  (Fig.  lyy), 
and  ujKJn  its  anterior  broad  pt)rtii)n  there  may  be  distinguished  an  antero-inti'rnal,  .in  antero- 
extemal,  and  a  ]K)Sterior  surface.  The  linea  aspera  furnishes  either  the  origin  or  the  insertiun 
for  a  large  number  of  muscles. 

The  iiijcriot  rxircmily  of  the  femur  is  ver}'  broad,  and  jiresinls  two  convex  ciikMcs 
I  Fig.  T37I,  a  larger  inlmuil  londyli-  and  a  smaller  txlrrnal  condyle,  which  are  directeii  |h)s1i  ri('rlv 
and  are  separated  from  each  other  by  the  iulcrcomlyluid  jossii,  an  inlrrcondyloid  line  se|..ira'ing 
this  fos.sii  from  the  popliital  surfaci.  Anteriorly  1 1'ig.  i")  the  cartilaginous  surfaces  of  both 
(ondyles  are  <i)iitinuous  with  an  artiiuiar  surface,  the  punUar  siirjitir.  which  is  concave  from 
.-^ide  111  side  ami  convex  from  alxne  downward,  so  ijiat  the  entire  articular  surfiue  of  tlu'  lower 
end  of  the  fcniur  i>  shapi<l  sonuvhat  'ike  a  horses'-oe.  .Mhjvc  the  conu\'.s  upon  llu-  latiial 
>urfaiis  i>f  the  lower  end  ot  the  bone  are  -ituated  two  rough  and  slightly  ijrcniinen;  processes, 
the  epiciiiid}  les  1  Fig>.  1^7,  !,^8,  and  141  I,  whicli  are  lemieii  tile  Inlirniil  ij>iiondyle  and  the 
ixlcrihil  ( picoudyh .  The  lowir  portions  of  the  lips  ol  the  line:'  asjH  ra  run  downward  to  the 
cijicond\le>.  wiii.  h  gi\i  origin  to  the  ga>l^u^llemiu^  muscle. 


I.ikt-  liii'^i  "I  ll"  I'lii^;  Ikiiii-.  ilif  I1  iiiur  i^  iI>mIi'|i,,|  (rojn  .1  ni.iplnM  .il  .mil  l»i>  [iriiii.ir'.  i|n|ilnsiM|  c  riilrrs.  Tli'- 
ciia]ili\-i  .il  • '  iiu  ;  iiiipi  .ir»  .1-  r.i'l;.  .1-  tin-  -ivrnihunk  of  .tnlirvciiii  lifi  .  .inil  \\U\U  ilir  Ii>wir  riiiplnsi'al  ici.lir 
I-  u»u.4Uv  vi^ilili-  .tl  litrlli,  l!u  <  riiii  r  lt>i  tlu-  hen)  ut  ilti-  ti-titur  ilm  .  tint  ,i|>|  r.it  until  .itirr  tli, 1)1  i.tt  tlu-  rtut  (if 
(lu-  nrsi  vi'.irK  \i  a  ;att  r  {m  ri'Ml  *[Miia!  rpiphy-it  al  •  cnUTN  a|ijMar  iti  ilii  ^*r(  alt  r  fr-.hanlti  ifourtti  vciri  .iiu! 
in  tiir  loMT  triH  haiitrr   ■  tlintii-iiih   'n  fnurtrrntn    vrar*. 

Mlliiiu^l!   Ilii    1  tfUr!    fur  tlu    I«^>',  r   inulianliT  aji,ic.ir^  !alt  r   iti.in  .vw    nf   iIii-  oiIut  «pijilu>«al   « i  iittT-..   it    i-.    ii;r 


::■,   rjrv.-r-;-  :r:t-'  a  :.  -^r 


jT'T!--u::ir.!  ;-r--j:-i  !:■■",  ihi 


Ilind 


(jmit  tmiiiiiii/ir  Dninssici:  on  hcnit 


Nirlt 


(iniil  tiiulumlir    (imt!  imhiintir 


(111   lliilil 


Inltifhil 


Inliitrodinn- 
Irrir  liiif 

I  csser 
Innluinlti 


liitiiiitil  rpiit'iitlylf 


/    V 

Irnii 

I.'    ,    V/l/|/( 

In  cnwl 

liilrn  i 

n,!v 

l'i(f    /ilSM. 

Inliiivi'dv 

'lUll    I'illl 

Ins-  Ii7 

Piitilliir  ^niiiiii 


f'hs  Jin. 


/:-  ns. 


•Jfjrr. 


i  ! 

i   , 


Head 


I'littUar  siirfiii-e 


,W,rk 


(heat  troilnintir 


/ 

fiximiii!      :/ 
f/)iivi!((vlr      •§ 

J»>-      1 

Inlmuil    i\rtineiil  liiii 

'■/"'"'"''■''■    hiinr  lip  oi 

liiiiti  iispfni 

Li 

/  XlillKll        ^H 

Intmviiihiiml  Ji'ssn 
hi>r.  141. 

InliTinil  nmdyli' 

liiiirtivilKiiilmc 
tnnlutntir 


li<r.  140. 


Oliilivl 
tiilnivsilY 


Oilier  lip 
ill'  liiirii 
ii-'/iiiii 


i 


JidSf 


fiasf 


Api:\ 


liiT.  142. 


Apr.f 


Aiticiiliir  siirfiiir 


hi'.  14  i. 


i 


mmm 


THE   SKELETON   OF  THE   LOWER   EXTREMITY.  QQ 

first  to  unite  with  the  shaft  of  ihr  fimnr  (seventeenth  yearl;  then  fcillmvs  the  union  of  the  titichanter  majnr,  then 
that  of  the  heail  of  the  femur,  and  finally  (at  the  twentieth  year)  that  uf  the  lower  end  of  the  f.miir  with  the 
shaft  of  the  Ixine. 

THE  PATELLA. 

The  patella  (P'igs.  142  and  143)  is  a  Hat,  rounded,  disc-like  bone  whieh  is  nothing  more 
than  a  large  sesamoid  bone  in  the  tentlon  of  the  (|ua(lricei)s  fenioris  muscle.  The  ui)i)er  Iwrder 
is  broad  and  is  call(  the  base,  and  the  lower  jwrtion  of  the  Ixjne  terminates  in  a  point,  the  apex. 
The  anterior  surface  is  rough;  the  j)osterior  is  smooth  antl  covered  with  cartilage  for  about 
two-thirds  of  it.s  extent,  this  cartilaginous  .surface  being  ai)i)osed  to  the  iialdlar  surface  of  the 
femur  and  known  as  the  articular  surjacc.  The  posterior  surface  of  the  ajiex  is  not  covered 
with  cartilage  and  is  rough  like  the  anterior  surface. 

The   patella   is   formed   from   a   single  i enter    uhieh  dixs  not  ap|>ear  until  the  fourth  year.     Ossification    is    not 
comfilete  until  after  pulxTty. 

THE  TIBIA. 

The  tibia  (Fig.s.  144  to  147  and  150  to  152)  is  the  inner  and  by  far  the  larger  of  tlu  two 
bones  of  the  leg.     It  is  composed  of  a  superior  extremity,  a  sliajt,  .mil  an  initrior  extremity. 


if 


'\ 


■  \i\ 

I 


I 


internal  bonJer 


external  erest. 


/  f    .      \  ,'  antrnur  erftt 

[<}'    inteh.-i5cous 


errs/  tihin 

Flc.  147— .A  .section  of  ihe  Nines  of  ihr  cms  taken  at   alnrnt   the  middle-  of    iluir  IcriRlh  isc  h.  mali/ed). 

The  superior  extremity  is  tlic  thitkcsi  portion  of  the  lM)nc.  It  jiresents  two  condvits 
(Fig.  1511,  whiih  artiddale  wiih  tile  lower  end  of  the  fmuir,  and  are  knov  ,■>  the  internal 
and  external  eondyhs.  They  exliihit  ui)on  their  upjier  siirfatis  two  roim<led,  Iri.ingular,  sliglillv 
coniave  areas,  the  internal  and  external  superior  artiiular  surjacc,  for  the  femoral  condvles, 
whose  Kmiavitits  (espeiially  that  of  the  external  one)  are  mnsiilerablv  less  than  the  toinexities 
of  the  femoral  condyles.  These  areas  are  .separated  by  a  median  elevation,  the  inter, on<l\'ioid 
cmineme  or  spinous  process,  whit  h  presents  two  small  tidnTt  les,  the  internal  and  external 
i'llrrconjyioiil  tubercles,  and  in  front  of  and  Inhind  the  niiinence  are  small  shallow  deprosions 
which  are  known  respecli\el>  .i>  the  anterior  and  posterior  inlcrcondvloid  /ovv-    (Ki.,,r.  i:;,). 

The  artitular  r.uffacer,  arc  iKnindcd  by  the  aln  ^.,t  Veriicai  ijuii>   niaigii.  ••■  liK-  upper  i  mi 


1 1 


I 


lOO 


ATLAS    AND   TEXT-BOOK   OF   HUMAN    ANATOMY. 

Flc.  I44.'-The  ris^ht  tibia  seen  from  in  front  (5). 

Fi(..  145.  -The  rii;lit  tibia  seen  from  behind  (  =  )■ 

Vii.  I46.-Tiie  riyht  tibia  sen  from  the  outer  surface  (s). 

p„.  ,48.— The  right  nl)uia  >een  from  the  inner  surface  (s). 

Fio^  149.— The  right  tibuhi  seen  trom  the  outer  surface  (  =  )■ 

Fig  i<;o-The  til)ia  and  fibula  seen  from  behind  (p. 

F,r."  ,    .'  -The  upper  end>  of  the  tibia  and  f.bula  seen  from  above  (\) 

F,,'  ,^  -The  lower  ends  of  the  tibia  and  fibula  seen  Irom  below  (i). 


osily  (FiR.  .44).     The  entire  upper  end  of  .he  t.l.ia  is  bent  sl.ghth  backvNarcl 

of  the  Ijone  (Fig.  i4''l-  ,  .    ..^      Tt  ;<  iViirU  it  its  iunction 

The  shajl  of  the  tibia  is  of  a  distinctly  triangular  pnsmat.c  form.      t  .    thick  "^^^  J^^ 

..  .e  ..,>^;;-^;^->.  - -;  -;;r::  r—:^  "tde:  ::d  z:j. 

T  Tr'";an      nU.,  o      ^.i    Fi.'.       4.  --e.hat  S-shape.l  and  beginning  at  the  lower 

Mb    in^         c  '1      .1.0  i^rrual  and  ,.lrrnal  surjacc,  while  the  e,uall>-  shaq- 

n.arg,n  of  ^'^^.  ^^T^';:^^^'\^     ,;,,,,,,  ,,,,„,  „u.  nbula  (Fig.  147).  is  si.ua.e.l  between 

;;::=:;:?  ^.Z:::^:'   W  third  bord..  .  .he  ti...  is  .unded;    .  separate,  .he 

S£SSS3iE  ===== 

*'»*■  "■^' '"  "•  "■  ;"•■  "'T'  't'l", :::;'"  »:^  ;;;r;::;;r :;.".;;  i':,i-» 

licit    bcini^   covered    with   cartilage 


f'xtcnuil 


Infrtif^liiioid 
miirii'i" 
Iiitirnal 


IntmomWIoid  nninaiiY         Xninihr  s„rf,„r 

lor  Jilnitd 


Superior       „ 
extremity       ^^ 


liilinm!  (■■ukIvIi 


liiUrmd  siirfdCf 


I'oplihvl  lini 


I  ibiihir         y^.  .» 
notill 


Inlirior  iirliiiihir  sinlihY 

lio.  144. 


hiltrihil 
niii/livlii' 


(hvovi-  ,<>i  iiilri/ui/  iiiiillivhi'- 


n>'.  rn. 


i'.xtinml 
sinldcr 


Shaft 


Xrliailiir  sinUiiT 
,1/  mnllivhi'^ 


InlVrior  (iilmiliir 

■^lllldii 

//.'.  140. 


Inferior  extremity 


lii'iii,"    iiili.llliir   -.ll  hiic 


I  I 


i.l 


i 


-.  \ 


A  iitciii'i- 
crest 


Articular  s.irface    Apex  (f- 
of  head  Imid 

Superior 
extremity 


rosterior  crest         I  xteri  al      ; 

creii  I 


Siitrient 
foniincii 
Intcnuil  siirfiice 

Shaft     I  .^tennil  siirfncc 


Hani 


AiHerioi-  Cif-'i 


Arliiiiliir 
surface  ot 
iiHillecliis 


Aiiiitii:!-  iitrriro 


f'osterit.r 
•iiirfiice 

fig.  l-fS. 


.     Inferior  exti-emity 

I'croiicdl 
sulcus 


r.r.    140. 


I  \icnnil 
UlllllCl'lu- 


:■!.}  iJ  /I'VMi 


Tilhinnlly  ol  lll'iti 


f-ig.  IW. 

hihiiinl  ..■iiilr'liii 


/'croucdl 
sulcii'^ 


[iliiiiliii   ..iiiuu;   01 


I  \rirniil  ivnilvlf 
11,11.1  of  III'"'" 

Ailiiiilii'   ■•"I- 
l,i,r   01    i'llrr- 

„.il    HUlll'OllI' 


.]/:r\  01  Ik'I'I 


Inrrrrtiil  inlfiroii 
tlvlortl  tiil'iiilt 


I'o.l.  nor  mtfn-on.Moul  /.'-""       ^  ^^_^    ^^,  u,U-r,on,hloid  Ulhnl. 


l„„no,    olloolor   -'»/.„.■  01  llho 


i-<'.  h2. 


if  I 

1! 


iiil 

Mill 


i 

11 


;i     1 

J                 ■ 

1 

r  1 

^ 

^fttsa 


Jd^'... 


:;^;r^ 


F'?^^^ 


THE  SKELETON   OF  THE   LOWER   EXTREMITY. 


lOI 


The  diaphyseal  center  of  Ihe  tibia  appear^  in  the  seventh  week  <if  emtiryonii  life,  liul  usually  several  days  later 
than  that  of  the  femur.  The  upper  (proximal)  epi[)hvsis  ossit'ies  immediately  before  or  after  birlh.  the  distal  one 
not  until  the  iK-ginning  of  the  second  year.  The  lower  epiphysis  unites  with  the  shaft  in  the  eighteenth,  the  upi>cr 
in  the  twenty-.seeond  year. 

THE  FIBULA. 

The  fibula  (Fiffs.  148,  140,  151,  and  152)  i.s  a  .slender  bone,  and  although  its  upi)cr  extremity 
is  situated  lower  than  that  of  the  tibia,  it  is  but  a  trille  shorter  than  that  lK)ne,  since  it  ])rojects 
below  it  (Fij^.  150).  It  is  situated  ujmn  the  outer  side  of  the  leg,  and  is  composed  of  an  upper 
extremity,  a  shajt,  and  a  hr'vr  extremity.  The  sujjerior  e.\trem-'v  is  formed  by  the  head  (Fig. 
148),  the  inferior  by  the  external  malleolus.  The  head  is  dist..K  v  thickened  as  comi)ared  with 
the  slender  shaft  of  the  txiiie,  and  its  upjiermost  j)ortioii,  whidi  is  t  ,e(  ted  outward  and  somewhat 
backward,  is  known  as  the  apex.  It  jjresents  a  small  llat  articular  facet  (Fjo.  148)  for  articulation 
with  the  tibia. 

The  sJiajt  of  the  fibula  is  of  a  distinctly  triangular  ])rismatic  form,  and  its  three  surfaces  are 
ir'i  rnal,  external,  and  posterior  (¥\g.  147).  The  three  Iwrders  are  very  sharj;  and  do  not  ])ursue 
straight  course  on  account  of  a  distinct  torsion  of  the  lower  end  of  the  bone  alxiut  its  longi- 
tudinal axis;  they  are  known  as  the  anterior,  external,  and  internal  erests,  the  anterior  crest 
separating  the  internal  and  external  surfaces,  the  posterior  crest  tiie  i)osteri<-r  and  internal 
surfaces,  and  the  external  crest  the  ])osterior  and  external  surfaces.  The  inn  surface  also 
presents  a  feebly  developed  border,  the  interosseous  ridge  (Fig.  148),  so  that  the  libida  may  \k' 
said  to  |x)ssess  four  Ixiniers.  The  nutrient  foramen  is  situated  slightly  alxjve  the  middle  of  the 
posterior  surface  and  at  a  lower  level  than  that  of  the  tibia;  il  leads  into  a  canal  wiii(h  is 
directed  downward 

The  tibia  and  the  nbula  have,  therefore,  different  relati<!is  than  do  the  radius  and  the  ulna,  a 
surface  of  the  fibula  (internal  surface)  being  directed  toward  a  lK)r<ler  of  the  tibia  (the  interosseous 
ridge),  and  the  similarly  named  surfaces  of  the  two  Ixines  do  not  lie  in  the  same  planes  (Fig.  147). 

The  inferior  extremity  of  the  tibula  is  formed  by  the  external  malleolus,  which  !:.  longer  and 
more  iminted  than  the  internal  one.  Its  inner  aspect  i)resents  a  llat  articular  surface  (Figs.  i.j8 
and  152),  which  is  immediately  contiguous  to  the  inferior  arlitular  surfaic  of  liie  tibia,  and  its 
external  circumfereme  is  marked  by  a  shallow  groove  for  the  tendons  of  tiie  two  jieroneal  muscles 
(Fig.  I4()).  .\longside  of  the  articular  surface  there  is  always  a  de[>ressi(>n  for  the  attachment 
of  ligaments  (Fig.  148,-.;:). 

'I  he  dia[iliyseal  i  enter  of  the  fibul.i  appears  somewhat  later  i  that  of  ihe  tibia  (eighth  wi'ek  of  fetal  life),  and  thi- 
epi[)hvseal  centeis  develop  at  a  cimsi<lerably  later  period,  the  ini'  nor  in  the  M'Cond  anri  the  ..iiperior  in  ihe  third  or 
fourth  year.  The  inferior  epiphysis  unites  with  the  ^h.ifi  U-fore  the  supirior,  .1^  i-  the  i.i-r  in  Ihe  tibia,  but  ihe  uincin 
of       .h  cKcurs  later  than  in  the  tibi.i- 


THE  BONES  OF  THE  FOOT. 

The  skeleton  of  the  foot  (Figs.  15,:;  to  155),  like  that  of  the  hand,  consi.sts  itf  three  divisions, 
the  tarsus,  the  metatarsus,  and  the  plialanf^es. 


i 


0'  r»   .-:-fi.i'  ::\i. 


I02 


ATLAS    AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 

Fio.  IS3.-A  frozen  preparation  of  the  bones  of  the  foot  seen  from  the  plantar  surface  (|). 

Pij,  i54._The  same  prepa.jtion  seen  from  the  dorsal  surface  (|). 

pjg  i55._The  same  preparation  seen  from  tlu   outer  si('  ■  (5). 

Fio.  156— The  right  talus  (astragalus)  seen  from  below  (i). 

Fig.  157— The  right   talus  (astragalus)  seen  from  above  {\). 


THE  TARSAL  BONES. 

The  tarsus  (Figs,  m^  to  i^s)  consists  of  seven  l>ones.  (i)  The  talus  or  astragalus:  (2)  thc- 
calcaneus-  (x)  the  navicular  or  scaphoid  bone;  (4)  the  cuboid  tone;  an.l  (5  l<>  7)  Uwcxfrnat 
middle  and  inlerml  cuneijorm  bones.  Only  in  the  distal  portion  of  the  tarsus,  where  the  cuboid 
articulate,  with  the  three  cuneiform  bones,  is  there  an  indication  of  an  arranger,  'in  nws  as  m 
the  caq.us,  and  in  further  contrast  to  the  hand,  a  single  tarsal  bone  articulates  wi,h  both  bones 
of  the  leg,  while  the  can)us  articulates  with  the  radius  only. 

THE  TALUS. 
The  talus  or  astra<^alHS  (Figs.  156,  157)  is  ^  short  hone,  irregularly  cuboid  in  shape  and  is 
composed  of  a  bodv  and  of  a  head,  the  constriction  between  the  two  being  termed  the  neck. 

The  bodv  IS  the  thickest  an.l  most  posterior  portion  of  the  bone.  Its  upper  surface  presents 
a  cartila-^inous  trochlear  surface,  the  trochlea  (Fig.  157),  -ith  which  the  tibia  and  fibula  articulate, 
ami  it  possesses  three  .surfaces,  a  largo  superior  one  and  two  smaller  lateral  or  s.  The  superior 
surface  i.  convex  in  the  longitudinal  (sagittal)  axis  of  the  bone  and  concave  from  side  to  side;  it 
is  broad  anteriorlv  and  narrow  posteriorly.  The  lateral  surfaces  are  ahiiost  hat  and  approxi- 
mateU  triangular,  the  external  one  being  much  larger  than  the  internal.  The  externa  surface 
is  known  as  the  external  malleolar  surjaee;  it  forms  the  outer  side  of  the  astragalus  an.i  is  a,n- 
tinucd  upon  a  strong  process  of  the  bone,  the  external  process  (F.gs  154  and  156),  which  is 
directed  outward.  The  internal  surface  forms  a  part  of  the  inner  side  of  the  astragalus,  he 
remainder  of  which  is  rough,  and  is  terme.l  the  .Uernal  malleolar  surface  Behin.l  the  trochlea 
and  directed  backward  is  the  posterior  process  (Fig.  157^  which  is  notched  l^-  a  broad  groove 
for  the  tendon  ot  the  flexor  hallucis  lonRUS.*  The  lo'^rr  surface  of  the  bone  (I-.g.  156)  presents 
a  <listinctlv  concave,  abnost  transverse,  ovoi<l  articular  facet,  the  posterior  articular  facet,  for  the 
calcaneus,'  whose  outer  portion  lies  upon  the  lower  surface  of  the  external  process,  while  its  inner 
and  posterior  portion  is  upon  the  correspomling  surface  of  the  posterior  process. 

In  iron,  of  this  articular  facet  is  situated  a  broad  groove,  the  sulcus  tab  (fig.  155),  which  is 
wider  externallv  than  intemallv  ami  the  floor  of  hich  is  roughened.  Together  with  the  similar 
groove  of  the  calcaneus  it  f,.rms  the  sinus  of  the  tarsus,  which  is  Idled  by  ligaments. 

In  the  region  of  the  neck  the  lower  surface  of  the  astragalus  in  front  of  the  si.u  >  :ali  i.resents 
an  oblong,  ^lightlv  •  -ex,  artictdar  facet,  i.arallel  to  the  posterior  one,  and  known  as  the 
middle  articular  facet  Un  i.e  calcaneus,  and  l.>rdering  upon  this,  and  forming  a  portion  of  the  head 
of  the  talus,  is  a  small,  slightly  convex  elliptical  anterior  articular  facet  ,or  the  calcaneus 
(Fi;.;.  156'!. 


*  Tlicrc  mav 


„nsrqvK.ntly  Ik-  ,li.tin«uishe<l  upon  thr  (-"sU-rior  i.roci-ss  an  h,U'r,u,l  an.l  an  cMcrm,l  tubercle. 


PhMlanges 


Meta- 
tirsas 

Hases  of 
meta- 
tarsal "  ■  " 
bones 


Tuberosity 
jf  meta- 
tiirsal  I' 
Oroove  '''' 
tendon  of 
freronacus 

lonfin.-i 
I  iherosiiy  of 
filboitl  boms 


fixternul 

timeiform 
hone 

Tarsus 


niiiitiinx  III  of  itiiiit  It 
I'Inilnnx  II  i>/  iHii't  II 
nhiihin  V  /  !>/  i/ZyvV  // 


\\ 


llivil  el'  liilii-' 

livchliii  of  lulus 
I'xliriiii!  fiiviTS'i 

Ol    llllll'i 


(  iilniiirii'i 


I  xicniul itioiis-'  oj  tiilurosily 
of  ailro'iiu'^ 

fi.ir.  li'' 


liihirosily  of  ailaiiti 
(iiitcniii!  pnri's^J 


lis/.  n4. 


J"  ■ 


•■  !i  ,: .  .  I  . '  -'■»'  if-  i-'r  Wvrk'i 


1 

- 

1 

I 


I  i 


•13 

J" 


t/5 


if 


1  it 

I  - 


a 


i'^r!. 


=1     .li'^'^ 


THE   SKELETON   OF   THE   LOWER    EXTREMITY. 


lO': 


The  neck  is  <listinctlv  conslricte.l  only  upon  the  uj.pcr  ami  outer  surface;  upon  the  lower 
and  inner  aspect  it  is  not  'sharplv  defined  from  either  the  head  or  the  body  .>f  the  bone. 

The  I,ea.l  of  the  talus  (astragalus),  the  rounded  anterior  extremity  of  the  bone,  presents  an 
ellipsoidal  articular  surface  for  articulation  with  the  navicular  bone. 

Th..  pos„.ri,.  ,,r„...ss  i,  sHm.-unn.  an  in,l.,,cn,Km  U..u;  a,„l  is  Uun  ,l..i«n.u,..l  as  .lu-  ,.  >.„„..,„.  U  r,.pr,.s..n,s 
uhal  is  usually  an  in(l.']KnilaH  Urn-  in  thr  lo'vcr  viTli-l)raU'.s. 

THE  CALCANEUS. 

The  a,lca,„us  ,Fi,s.  .  s8  to  ,60)  is  the  largest  of  the  tarsal  bones,  an.l  fornis  the  postero- 
inferior  portion  of  the  tarsus.  It  articulates  with  the  talus  iaslr..^.!,.)  by  nu.ui.  o,  '  --•■  '™  - 
facets  an.1  with  the  cuboid  bone,  an.l  has  its  longitudinal  ax.s  .hrected  from  behmd  loruanl  and 

hli'ditlv  from  within  outward.  .        ,  .  ,         ,  ■,     ; 

The  nudn  portion  of  the  Ix.ne  is  terme.l  the  b<nly.     The  ,.osler>or  t luckened  extremUy    . 
known  as  the  >ub,n.i,y  an.l  projects  posteriorly  far  beyon.l  the  remain.n,  bones  of  -h''  f-'t;   >  > 
plantar  surface  presents  two  pro  esses  or  tubercles,  the  h.UnuU  an.l  n:lrnu,l  proass  (1  „.    .,V, 
a„,l  in  front  of  the  lulxrositv  is  tlat  and  cvere.l  by  the  l.,n«  plantar  hKanunl  ,see  pa^e  uO- 

Up..n  the  upper  aspect' ..f  the  calcaneus  (Fi,'.  .60^  n.n   be  ..bserve.l  the  three    acets  f.., 
,,„„,;ui.,„  wi,,;  Ihe  ,alu>  .astragalus);    they  are  known  as  the  posUrior,  „ud^,  an.    a,.r,,,r 
,rnn,l.,r  ja.rls.     The  posteri..r  is  the  largest  an.l  is  marke.liv  convex,  the  mul.lle  an.l  an  enor 
are  ^l.htlv  oncav..  an.l  the  anteri..r  is  the  smallest.     Th..  mi.l.lle  facet  hes  upon  the  susten  a 
.ui.,m  tali'.  an.l  la^tween  the  nn.l.lle  an.l  posteri.>r  i>  a  ;.r.>ove,  the  sulru.s  n,lnn,n.  winch  »  wuler 
evternallv  than  internallv  an.l.  together  with  the  suU  us  tali.  f..rms  the  si,u,s  o,  ihr  l.nsus 

The'  mark...llv  conca^..  internal  surface  .,f  the  cal.  aneu>  (Fi,.  .  58)  presents  a  broac   process 
,,,^.  ,„,,,„„,„!„,„, „li,  which  projects  towar.l  the  talus  ,astr.,alus,  an.l  bears  th..  muldle  face, 
f.,r  arti.  ulation  .  i.h  that  lx>ne.    Below  i,  is  a  bn.a.l  «r.«.ve.  the  .lirect  contmuati.m  ..f    >  ,t  upon  ,h.. 
,K>M.ri..r  pnKess  .,f  the  talus  (astragalus),  kn.nvn  as  th,.  ,r,.,.r,.  /or  llu  //..v.r  h.Uuas  /,.»,». 
\  similar  but  shall.nver  ,r.Hne  is  situate.l   u,,..n   the   otiurwise   Hat    vert.cal   external    ^urfa.e 
of  ,he  lH>ne  (Fi..^.  . .....  the  peroneal  s^roov,;  ami  al.ne  this  there  is  usuallv  a  sn,all  blunt  pn.jec- 

ti,.n  km)wn  as  th.    Innlihar  iperonml)  process. 

Th,  anterior  surface  of  the  calcaneus  pa-sents  a  sa.l.lleshape.l  tacet,  f..r  ar,uula„..n  ^^>lh 

the  culx)i(l  bone. 

THE  NAVian.AR  BONE. 

The  ,u,vieular  ..r  sraplwi.l  In.ne  (Figs.  .(.,  an.l  .6.)  is  situat.'.l  at  the  inmr  m.Ic  ..f  the 
tarsus  be.w...n  the  talus  (astragalus)  khiml  an.l  the  three  .uneif..rm  b-n.s  m  lr.,nt  .1m«s.  15s 
.,„d  . ;  0  It^  l"ng  aNis  is  place.l  transversely  to  the  axis  of  the  f....t,  ami  i.  i^  cmux  anter,..rly. 
markcllv  cn.ax,  i.os,eri..rly,  ami  .listinctly  cnv.'X  uiK.n  its  .lorsal  surface.  Near  th..  mner 
lx,r.l..r.)f  tliei^antar  >urfa.e  it  presents  a  strong  rouml.d/«/«mv//y. 

Th..  ...ncave  p..steri..r  >,.rfa...  .>f  th..  l.me  (Fig.  .(.,,)  f..rms  th.'  mm  ket  for  th..  lua.l  ..t  the 
talus  (astragalus.;  the  slightlv  ...nv.x  anteri.,r  surface  (Fig.  .(-.>  exhibits  thne  facets  f.>r  ,h.. 
three  cuneiform  lx,nes;  an.l  the  external  surface  presents  a  small  nat  inconstant  facet  for  the 
cuboid  bone. 


I 


i  I 


I    i 


104 


ATLAS    AND   TEXT-BOOK    OF    HUMAN    ANATOMY. 


riRht  calcaneus  seen  from  the  inner  surface  (5). 
right  calcaneus  seen  from  the  outer  surface  (;). 
right   calcaneus  seen   from  above   (i). 
right   navicular   hone  seen   from   behind   (J). 


Fig.  158— The 

Fig.  159 — The 

Fig.  160. — The 

Fig.  161.— The 

Fig.  162.— The  right  navicular  bone  seen  from  in  front  ( 

Fig.  163. — The 

Fig.  164.— The 

Fig.  165.— The 

Fig.  166.— The 


right  cuboid  bone  from  the  inner  surface  ( j). 
right  internal  cuneiform  bone  si(  n  from  in  front  (j). 
right   middle  cuneiform  bone  sccii   from  behind   (|). 
right  e.xternal  cuneiform  bone  seen  from  behind  (j). 


THE  CUBOID  BONE. 

The  cuboid  bone  (Fig.  163)  is  situated  on  the  outer  side  of  the  fool,  111  front  of  the  anterior 
extremity  of  the  calcaneus  and  behind  the  bases  of  the  fourth  and  fifth  metatarsal  bones  (FIrs. 
133  and  154).  It  is  irregularly  cul)oid  in  form  and  its  inner  border  is  longer  than  the  outer  one. 
Its  dorsal  surface  is  convex,  its  anterior  surface  jjresents  two  articular  facets  for  the  bases  of  the 
fourth  and  fifth  metatarsal  bones,  and  its  posterior  surface  is  .siiddle-shajied  and  articulates  with 
the  caliancus.  The  internal  surface  (Fig.  16;,)  presents  a  flat  articular  facet  for  connection 
with  the  external  cuneiform  Ijone.  and  a  small  inconstant  one  for  the  na\icular,  and  the  external 
surface  is  narrow  and  forms  a  part  of  the  outer  U.rder  of  the  foot.  The  i)lanlar  surface  presents 
a  llatlened  tuberosity  (Fig.  15,^),  in  front  of  whi.  h  is  situated  a  bro;  groove,  the  peroneal  groove, 
which  is  lined  with  cartilage  and  accomnuxlates  the  tendon  of  the  p^  loneus  longus  muscle. 

THE  CUNEIFORM  BONES. 

The  three  cuneiform  Ixines  (Figs.  Mn  to  i()())  are  situated  between  the  navicular  and  the 
bases  of  the  first  three  metatarsal  U)nes,  and,  as  their  name  indicates,  are  more  or  less  wedge- 
shaped. 

The  internal  or  first  cuneiform  bone  (Fig.  \<^)  is  by  far  the  largest  and  also  the  longest 
of  Ihi  three,  and  it  has  tiie  narrow  edge  of  its  wedge  directed  dorsally,  so  that  its  plantar  surface 
is  much  broader  than  the  d<.rsal  surface.  Its  internal  surface  is  directly  continuous  with  the 
narrow  dorsjd  one;  the  anteri.ir  s.miUinar  surface  articulates  with  the  base  of  the  metatarsal 
l)one  of  the  great  toe;  the  i)Ostcrior  triangular  surface  articulates  with  the  naxi.  nlar  Inme;  and 
the  external  surface  is  in  conliut  \vidi  the  middle  cuniiforin  and  with  the  base  of  the  second 
metatarsal  Itone,  and  exhibits  articular  facet',  for  both. 

The  middle  or  second  cuneifoim  bone  Fig.  i(>5i  is  the  smallest  and  the  shortest  of  the 
three.  The  thin  edge  of  its  wedge  is  direUed  downward  and  is  almost  concc  led  between  the 
external  and  the  internal  cuneiform  Inmes;  ii>  base  forms  part  of  the  dorsal  surface  of  the  foot, 
and  its  posterior  surface  presents  a  triangular  articular  fai .  t  for  the  navi.  ular  In.ne.  The  middle 
(  unciform  also  articulates  with  the  second  metatarsal,  and  with  the  external  and  intirnal  cuiu  ifomi 

Inmes.  „    •    ,        i 

Thf  external  or  third  cuneiform  bone  (Fig.  if/))  is  some  what  larger  (especially  in  length) 
than  the  middle  one.     Its  thin  edge  is  likewise  directed  downward  and  its  broadest  surface  looks 


Po<itmor  nrtiriihr  facet 


M  Ukl  1 1'  (lit  i III  I  111-  facet 
A  ntcriiir  articular  facet 


Articular  liicet 
for  ciilioid 


Sa^tciitacaliiiii  tan 

Anterior  articular 
facet 

Miildle 
articular 
facet 


Sustenta- 
culum tali 


fi.r  I5S.  iiroovefor  tnuion  luherositv 

,   il"-     iZru.       Iiii'cr  rroccss  Of 
haUm-is  loii-iis  tuherositv         . 


I'ostcrior  articular  facet 


Sulcus  calcanci 


Middle  articular  facet 
Anterior  articular  facet 


Articular     l  | 
facet  for     '  \ 


Articular  facet 
for  cuboid 


Sulcus 
calcaiiei 


Po\terioi- 
articular  laerl 


Hodv 


/  4".  it)0. 

lulicrositv 


cuboid 


1  ubcrosity 


,.  .  ,.„,       Iiocblciir iiroccss 

Outer /aocc^s  '  I'nvneal  aivove 

of  lii'ieivsily  llfr.  IVI. 


lifr.  101. 


Articulw  facel 
(Head  of  talus) 


Articular  facet  (mid   cuiiciloim  hoiicl 


Articular  facet 


,.  ii'il-  cnncilorin  hour' 


Articular  facet 
I  metatarsals  l\'  and  I  1 


rig.  I()2. 

Articular  faci't 
i,yt   eiiiiciliiriu  boiiei 


Atllittlill    Ittirl 
(/liiM    i'l  miluliii':il  III 


I io.  Ill/ 


,4i  riiiilii'-  h'i't'f 


Iil;.  Itn 


Articular  facet 
ie\t    euiieiform  hoiiei 

fll'.  I  Hi. 


Ar^inilii'   III''' 
.(>/,   iU'tfirorni   iuinr) 


Annul'"  I""'      . 
ii'iiliii  l'i"iri   ^\ 


Aili'Ul'ii   hurt 

I'lll't'lil    th"tll 


I  if,'.  100 


I 

:.     1 

'i  ! 


t-l 


u 

m 

11 

i*»-i* 


THE  SKELETON   OF   THE   LOWER   EXTREMITY. 


105 


..a.!  .'^    .0...  of  the  foot.    T,  .niculate.  .i.h  .he  navicular,  cul..!.  and  .iddle  cuncUo... 
and  v>     .  the  second,  third,  am!      urth  metatarsa.  bones. 

THE  FIVE  METATARSAL  BONES. 

r:zt.:-i::i^:'^t:t:.'f::p^^^  -.  »...■ »-<  '^^ 

„,  ,h.  nr,,  ,-»«,.,  a  broad  plamarpr,,..™,.,,   ,1,    '"^^''^^^^  „^,  ,„^,„„,,  „,  „„  „■„„ 

.     ,      f , hi- hisc  .il  ihr  first  pr.stnts  ;i  sint;!'   f:i' <■' 

inl.rnal     un.ifor.n,  an.l  tw,.  lal.nd  ,  u  ,H  for  ,h.  .h>r  1  "'  '  ■  ■ '^^^'     ", „;,„;.!  ■  m-  for  Ih.  .M- rn,.l  ,  un.if  .rm.  ami  an 
..U.rnal.,n..for.h..f..unhm..,a.ar.aUK,m.;  '';'' '"^   Y^     '   ^  ^  ,   ,,„,1,„„,  .-.f.h  m.-.a.ar.al   ...m-;    un.l   .h..-    -a.-  of 

;;:.^;;;t;r:;c,::;:"';i- -:f:::r a„„  .,„  ^ ..-^•^  .-^  -  --- ---  -- 

Ti.  .,..  or  .he  n..aa.a,  ,.n..  panic.a.v  .hose  "f  t.u.  s^l  ..  d.  I;^^;^;-— — 
,,.,er  .oward  .heir  heads  and  e.hii,,,  a  — 'j-;^-  ^^'^^  .^rian.ular  pr.sn.a.ie 
the  dors..m  of  the  .".k,..     In  eon.ras.  to  the.r  quadrangular  ba.cs, 

^"-:rhe ...  of  .he  second .  .he  .d.h  .e.a.arsa,  -;;^;;;;; -;;::-'::;::  \:r:iz 

compressed  f-om  >ide  to  side.     Thev  presen.  -';'"- V"^'^!^^;  ,,.,  f„,  ,,ieula,i..n  w„h 

•iir-ion,  .hich  e..end  far  ..p. he  ,   anUr  s.r  .ee  ;        ;^,^;;;';  ^  J^,^^,,  „„„..„.,  ,„.  „.• 

•he  l,ases  of  .he  ,,rox,mal  phalanges      On  .he  la.c    U  _  .^^_  nH.....ar>al  hone 

a..achn.en.  of  hga.en.s.  an-i  t^  'f"-.-'    j     :,:';;  l,,.  ,.o  eo,..ant  sesan.oi.l  hones 
presents  .wi.  concave  articular  faiel>,  sei)ar.u..l  in 

of  .he  grea.  toe. 

THE  BONES  OF  THE  TOES.   PHALANGES. 

Ler  ,o.t  ar-  .  o.sideraMv  ..orU-r  an.l  .nore  ^i>"''>-  ;-     -;;    ^.  ^     „    „„.  ,  ,,„.,  .i,H 

In  other  respec.s  ,he  phalange.  ,.t  .he  .,k.  are  ahn.M  ,  -  >'       ^  ,,,,,,„^,, 

U.e  exception  of  irregularities  ..f  devel.,pnten,  .  nch  :m.       .         u  .i^^  .^.^^^  J^^^^,^     ,^^ 

of  the  .wo  outer  toes  an-l  are  lar,..h  ,.,  W  ..urflmt.-l  ...  .  u           .->  >■    ^                      ^^^^^^^^^^^^,^. 

,.n,..  .,f  these  two  toes  are  -"l^i'^^'-  .>r..  U..dlv  e  en  .h     -        1  ^^^^^  ^^^^^^^  1^^^^ 

and  in  all  the  toes  it  is  onlv  the  pr„untal  pha  ,n«e-  da    .            a  ^  ^^^^^  ^^^  _^^^  ^,_.^^, 

A.  in  the  hand,  each  ,>halans  Kes..n.>  a  /.„sr  and  a  Inn  hl.„.  an,. 
phalanges  termina.e  in  an  »/Hi,w«J/  lul« rosily. 


io6 


ATLAS   AND   TEXT-BOOK   OF    HUMAN    ANATOMY. 


THE   SESAMOID    BOf  ;  ,   OF   THE   FOOT. 

Two  sesamoid  bones,  remarkable  on  account  of  their  sixe,  are  constantly  found  at  the 
metatarsophalangeal  joint  of  the  great  toe  (Fig.  153).  Inconstant  sesamoids  are  also  found  in 
the  tehdon  of  tlic  peroneus  longus  muscle,  at  the  interphalange;i '.  joint  of  the  great  toe,  and  less 
frequently  in  tlie  tendon  of  the  tibialis  posterior  muscle. 


It  \ 

u 


THE  SKELETON  OF  THE  FOOT  AS  A  WHOLE. 

The  skeleton  of  the  fcxH  (Figs.  153  and  155)  difTers  from  that  of  the  hand  not  only  in  the 
numlxT  and  form  of  the  component  elements  of  the  tarsus,  but  also  in  certain  peculiarities,  chiefly 
due  to  the  functional  adai)talion  of  the  foot  as  a  sup])ort  for  the  erect  body.  While  the  axis  of 
the  hand  is  situated  in  the  direct  continuation  of  that  of  the  arm  and  forearm,  the  axis  of  the  f(K)t 
is  placed  at  almost  a  right  angle  to  that  of  the  lower  extremity,  and  while  in  the  hand  the  phalanges 
take  up  alx)ut  one-half  of  the  length  of  the  skeleton,  in  the  foot  the  tarsus  alone  occu])ies  the  proxi- 
mal naif  and  tin-  metatarsus  and  f)halanges  together  form  the  anterior  half.  The  phalanges 
make  up  only  a  fifth  of  the  entire  length  of  the  f(K)t. 

The  foot  shows  a  much  more  ])'  mounced  curvature  than  do  the  relatively  llat  and  closel' 
approximated  i  ones  of  the  hand,  and  this  curvature  is  ])ractically  a  constant  one.  The  convexity 
is  directed  toward  the  dorsal,  the  concavity  toward  the  plantar  surface,  and  the  dee])est  jioint 
of  the  concavity  is  situated  at  the  apex  of  the  middle  cuneiform  l)one,  tlie  dorsal  surface  of  the 
same  l)one  likewise  forming  the  highest  point  of  the  middle  portion  of  the  arcii. 

The  arch  of  the  f{K)t  is  supported  posteriorh  bv  the  luberosit}  of  the  calcaneus  and  anteriorly 
by  the  heads  of  the  metatarsal  Ijones.  The  tarsal  arch  is  formed  exchisi\ely  b\  tlie  tarsus  and 
metatan  us  and  is  o])en  internally,  since  the  inner  lx)rder  of  the  fiKit  is  much  higher  than  the  outer 
one,  which  is  in  contact  with  tlie  ground  throughout  its  entire  length.  The  sinus  of  the  tarsus 
'see  page  102)  is  a  striking  formation  which  gradually  becomes  narrower  as  it  ])asses  inward 
and  l)ackward  from  the  outer  side  of  the  dorsal  surface.  The  tarsus  is  much  narrower  posteriorly 
than  anteriorly. 

The  i)halanges  of  the  second  lo  the  fifth  toe  do  not  lie  in  one  plane  even  during  extension, 
but  are  strongl_\-  cur\e(l  with  the  ccmvexity  upward  and  seem  to  Ix-  Ix'nt  ujion  the  heads  of  the 
metatarsal  Ixmes  like  claws,  so  that  only  their  ti])s  touch  the  ground. 

The  second  toe  is  the  longest  and  marks  the  longituflinal  axis  of  the  fcxit. 

fsuall)  till'  imly  tarsil  lumc-.  ikksc^miik  I'l^nti-rs  at  liirlh  an  Ihi-  i  alrant-us  (<ixth  niniuh)  ami  llic-  lalu^  (a-^lraKalusl 

fMviiilh  nidnthl;    the  icntor  for  the  uiljoid  apprars  at  alwut  tlu-  time  of  l)irlli.     'I'lir  t-xttrnal  i  umiforni  is  ihi'  l'ii>t  iif 

thrcr  luniiform  Uitiis  to  ossify    (lirsl  yi-arl,  thf  inliTtial  is  tile  nixt  (ihiril  yearl,  and  the  miildle  one  is  the  last,  its 

nation  and  that  of  the  navii  ular  Ixine  (KiurrinR  respeetively  in  the  fourth  and  the  fourth  to  the  fifth  year.    The  lal- 

aiieus  alone  has  a  <lis< -like  epiphys<-al  center  u|Kin  its  posti-rior  surface,  lorresixmdinK  to  thi  tulH-rosily.    this  aiF|K'ars 

ill  till'  tenth  vi'ar  and  fuses  with  the  rest  of  thi-  txme  at  from  the  tifteenth  to  the  sixteenth  vear. 

The  metatarsal  Uims  ossify  niui  h  earlii-r  than  ilo  the  tarsid  Umes  and  ossilii  ation  pri«eeds  in  a  manner  i|uile 
simiUir  to  that  of  the  mel,uarpal  Ixinis  The  diaphyseal  nui  lei  apjH'ar  in  the  eirihlh  to  the  ninth  fetal  wiik  and  the 
I'piphvseal  centers  also  are  like  those  of  the  nietaiarp.il  Ixmes,  appearing  in  the  third  to  ilie  fourth  \<.ir  .ind  not  uniting 

ollil  liie  <iiapll\stai  ><  iilel   Ulllll  ,lll<  1  puUliV. 

The  ossitHation  of  the  phal  inRcs  of  the  foot  als<i  i  orres|B)n<|j  exaetly  to  th.it  of  ihe  phalanges  of  the  h.iiid  The 
diaphvseal  centers  appear  in  th>'  third  fetal  nionlh,  the  epiphvs.-.d  .enters  in  the  third  lo  the  fourth  year,  and  the  union 
of  the  epiphysis  with  the  di.iplivses.  .is  in  the  iiiitatars,il  Umes.  oeeurs  after  pulM-rty. 


.•'•;.■;■■•  ■'■•■    ,■ 

'^•■'^'■'^•^.^•..Nl'il- 


til...,"..  ;.'.:<-r;v^  ■.■•)-  j; 


5^, 


I  iiiiiilmliiiiil   i/iviiliil'  salioii 

i'l   till-  iipiur  txtirmily  i>l   llif 

Iriiiiir 


I  oiiiiiliiiliiiitl  i^i:Kitli'l 
'•irfic'i  I'l'  till   i;i/'\iiiiii^ 


I  /.'.  los. 


Sift'  -QsiiS 


r 

1' 

- 

' 

! 

-;       i ;' 

Fig-  '69- 

lontah  section  of  the 


'.""^;"i/r;;/(v  oA  """"•'■ 


I'iS- 


171. 


f/cr.   170. 


'''''«'';;;!;::r'r^''S'''''''^'"'' 


.•V^f^v,!-'; 


Si/jrif" 


;  sic"""  • 


,;■  /,/»l/'(f  '■'■'■ 


Ichiii 


i, £ 


.;   Is 

'      -T 

iL 

■ 

IS 

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It   '< 


I! 


3jtJ 


W^ 


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ita 


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i 


SYNDESMOLOGY. 
GENF.RAL  SYNDESMOLOGY. 

The  bones  of  the  bodv  are  connected  . i,h  each  other  in  one  of  two  ways.     '^^^^^^^ 

Tie  of  cLnection,  allowing  of  a  nntch  nu.re  extensive  ran«e  of  mot.on  between  the  bones. 

SYNARTHROSES. 

The  svnirthroses  are  classiUed,  according  to  the  character  of  the  tissue  connecting:  the  ends 


Svmhoiid roses  are 


diaphyses  of  the  long  lx)nes  (see  pa-e  2 1).     An  example  !>  lurni. 
rib  to  the  manubrium  of  the  sternum. 


The  syndesmoses  .r,  sub-'^'ided  into  two  .roups,  true  sy,ules,noses  and  s,,uns  ,.c     pages      , 
,  in       The  true  svnd  c  ^lose  in  which  interosseous  hgaments,  which  n,ay  be  e  a>tu 

and  80).      The  tn  e  s>nd  ^^^^,  frequently  str..ngthene<l 

actually  connect  "^^^-^,^;,, -^::;;- :;:;;,;;1  ,  ,!,„,.  connected  with  the  tibia  by  such 
'  .  -  ,  •■    mass  does  not  con - 


bv  acccssor\' liijamer ,  ,  .■ 

e>,  wnieii  aie  .  ...  i„,ny  margms  by  means 


nect  the  bones, 


layer  of  |>eiio^toum  (see  jiai; 


e-  (yS). 


In  the  mixed  synarthroses  or  symfhyses  the  tissue  conne^ 
cartilage.     Typical' examples  arc  furnished  by  the  connection 


cting  the  e;-.', .  of  the  bones  is  libro- 
s  of  the  bodies  of  the  vertebr;u 


:h,. 


!  I  i 


!i 


]  I 


io8 


ATLAS    AND    TEXTBOOK    OF    Hl'MAN    ANATOMY. 


by  the  inlerverlcbrdl  fibrocarlilagcs,  and  b\'  the  connection  of  the  two  j)ubic  Ixincs  by  the  inter- 
pubic  /ibrocarliliii^f. 

We  occasionally  find  a  combination  of  a  synarthrosis  (particularly  the  syndesmosis)  with 
a  joint,  as  in  the  connection  of  the  sacrum  with  the  innominate  bone,  or  .a  lit  alar  spaces  may 
appear  within  the  symphyses,  and  such  arrangements  are  termed  half-joints  [ampliiar/lirosfs). 

DI  ARTHROSES. 

The  diarthroscs  or  true  joints  are  characteri/id  by  congruent  cartilaginous  surfaces  which 
a  separated  from  each  other  by  a  cppilhm-  s])ace,  and  are  provided  with  a  number  of  struc- 
tures, the  majority  of  which  ai  ibsent  in  the  synarthroses.  These  are  the  arlieular  capsules, 
the  ;it  ces,sor}-  ligaments,  and  the  articular  cartilages.  They  may  also  be  ])rovided  with  s])ecial 
structures,  such  as  the  interarticular  cartiuiws  or  menisci,  diverticula  of  the  synovial  membrane 
forming  synoi'ial  burscr,  glenoiilal  lips,  joint  cushions  fdcsignr.tcd  by  fliffcrcnt  names  in  he 
dilTerent  joints),  and  lx)ny  locking  mechanisms. 

The  articular  capsule  usually  surrounds  the  cartilaginous  articular  surfaces  of  the  con- 
tiguous Ix)nes  so  as  to  form  a  completely  closed  articular  ca\  ity.  It  consists  of  an  external  firm 
fibrous  layer,  the  fibrous  layer,  and  of  an  internal  softer  vascular  layer,  the  sy  vial  layer  or 
membrane.  The  latter  gives  off  microscopic  thread-like  \ascular  ])roces.-ies  of  irreg  .ir  sha])e,  the 
synovial  villi,  and  occasionally  it  forms  large  structures;  visible  to  the  naked  eye,  the  synovial  jolds. 

The  articular  cavity,  usually  a  capillar}-  space,  is  filled  with  a  \  iscid  fluid,  the  synovia. 

The  articular  cajjsule  varies  in  thickness;  it  is  sometimes  strengthened  by  accessory  liga- 
ments and  sometimes  interrupted,  .so  that  diverticula  of  the  synovial  membrane  jjrotrude  through 
its  ojjenings  and  form  syno\ial  burs;e  (see  also  juige  143),  whose  ca\ities  are  conse(iuently 
vlirectly  continuous  with  that  of  the  articulation  (communicating  synovial  burs;e). 

Accessory  ligaments  form  important  com])onents  of  the  articulations,  and  according  lo 
function  the  ligaments  of  the  Ixxlv  can  be  sulxlivided  into  the  following  classes:  (i)  Ligaments 
oj  fi.valion;  i.  e.,  those  ligaments  which  firmly  unite  iwo  bones,  as  in  the  syndesmoses.  (2)  Ke- 
injorcing  ligaments  of  the  joint  capsule;  tiiese  are  more  or  less  adherent  lo  the  capsule  itself, 
but  sometimes  apijca"-  as  independent  structures.  (,V)  Check  ligaments,  i.  c,  ligaments  which 
are  ca])able  of  limiting  certain  movements  of  the  joint.  (4)  Ligaments  oj  conduction,  i.  e.,  liga 
ments  whose  function  is  to  conduct  vessels  and  nerves  to  a  part  of  a  bone.  (5)  Ligaments  which 
take  the  i)lace  of  b<me.  These  last  are  found  in  those  situations  where  neither  fi.xation,  nor 
inhibition,  nor  any  other  of  the  usual  functions  of  a  ligaiiH'nt  is  recjuired;  they  extend  between 
])ortions  of  the  same  !;!;ne  or  con  wn  a  notch  into  a  foramen. 

The  interarticular  cartilages  or  articular  discs  (termed  menisci  when  of  a  Durelv  fibrous 
character)  serve  to  adapt  mutually  articular  surfaces  whii  h  are  not  com])letely  congruent.  They 
are  attached  to  the  inner  surface  of  the  joint  ca])sule  and  extend  for  a  varying  distance  between 
the  cartilaginous  ends  of  the  bones.  In  the  most  extreme  cases  the\  (li\  ide  the  articular  ca\ity 
into  two  portions,  so  that  the  articular  extremity  of  one  bone  is  in  relation  to  one  side  of  the 
articular  di.sc  and  that  of  the  other  lx)ne  to  the  other  side.  In  such  a  joint  the  articular 
extremities  of  the  two  bones  are  not  in  immediate  (intact  widi  each  other,  and  it  is  consequently 
possible  to  distinuniish  unilocular  und  bilocular  joi'its. 


GEXF.RAI.   SYNDKSMOI.OOY. 


109 


;;*;-irr:r:.;^;r':;:^ir,»,... m .-. ^-    - 

or  they  may  act  as  j.-int  cushions.  omnativ.  li^^u.  or  nhrocarlil- 

»"■'  r  v:x:-;"- is"r  ™::::.- ". '  - '  -  «^ - ^ 

part  striking  against  a  Ix-nyprop-u. on  ^^  ^^^^^  .^  .^  ^^,^„,^„,  ^^  ,,-„,^/,.  ,„„,. 

A  joint  is  usually  compose^!  of   -nU   ' -'"^  '  ^,,^,^,^^i„„  „■  ,  j,.;,,  or  ,.oninns  o,  th. 

Sometimes,  however,  three  or  nu.re  1-"^        ^  ^^    ,,,^^,,,„,,,  ,,,,,  „,  wl.eh  ea.e  the  jonU 
socket  arc.  formed  of  connective  t.ss 'e  component,       „ 
is  lermc.1  a  ,,-m/.m<m/  joinl.  m,,,,;,-..,!  acconUn-  to  the  shape  of  lluir  articular  sur- 

The  joints  of  the  human  bodv  --'-     '^_^    ,^      ?^,^^   ,3,  „,,;,,  join,>;    ..,  polvax.al 
faces.     These  sulxlivisions  are  as  loUows.    (i)   LmaNiaij 

joints.  ,  „f  ,^^.^  varieties   those  with  a  tran>ver>e  aNi^  an.l  tli"-«- 

The  uniaxial  joims  ^^ J^^^^^  :i  :::,::t:.: .r.  variety  is  at  ri.ht  angles  to  the  a., 
uith  a  l.mgiluainal  axis   '•    -         '  .         ,^^.  ,,,„  .j,,.,  are  coincident, 

of  the  moving  bone  and  in  the  second  Nanct>  tin 

1.  UNIAXIAL  JOINTS. 

A    -c      Tl„.  I,i,v'r  hnn<  or  'iiu'^lvmrn  belongs  in  this  (lass.      1  hese 
,a,  With  a  Transverse  Axis.-llu/n.  .    .  -_.  ^  ^^^^^.^^^  ,,^^,  ^,,,^^.^.^  ,„,,,,, 

joints  are  broad  an.l  the  articular  ^^^^^^^^^^  ,  .L.esi.nding  elevaii.n.  Thi^  c.n- 
Lhibi.ing  a  median  excavation  and  ^^J^^ _^^,^^  ,,,  ,,,.,a  ai^placenun,  of  the  hone, 
formation  together  with  -'-^  ^'^  ^  ^  .1  ,,  ..Android  and  i.  con.,uent.v  hori.onud- 
so  that  the  axis  ot  motion  comedo  wUh  h  ^^^  -„^^,^^„,  ^,^  Hexion  and  cxtensi..n.  and  m 
The  mo.ion>  permitted  by  a  gmglymoid  3  '"^' .'^  '  ;,;^,^,^  .,  „f  „u.  ginglynu,>  .,r  hmgc 
complete  extension  the  bones  fornj  an  ang  e  o  o^  ^  ^.  .^  ,  _^^ 
Join!  are  furnished  by  the  iiiterpbalangeal  ^    ^^    ^  ^^        ^  ,-,,,  ..,,avaUon  m  the 

=i:r:,tH:;:=^  j;-™--^^^^^^      , ,. 

examples  of  this  t"""  of  joint. 


Ill 


ill 


m:m 


H 


l!    ; 


S  I;  i  H 


no 


ATLAS    AND   TEXT-BOOK   OF   HUMAN   ANATOMW 


2.  BIAXIAL  JOINTS. 

This  class  of  joints  includes  the  ellipsoidal  or  condyloid  joint  and  the  saddle  joint. 

In  the  ellipsoidal  joint  the  convex  surface  of  an  ellipsoid  of  rotation  articulates  with  a  cor- 
responding concavitv,  and  the  two  axes  of  motion,  the  lesser  and  the  greater  axis,  arc  placed 
at  right  angles  to  one  another,  but  both  jiass  through  the  same  bone.  An  example  is  found  in 
the  atlanto-occii}ital  articulation. 

The  saddle  joint  is  formed  by  the  ajjproximation  of  two  saddle-sha])ed  surfaces,  /.  c,  sur- 
faces which  are  concave  in  one  direction  and  convex  in  the  other.  Each  surface  alternately 
forms  a  head  and  a  socket,  and  the  two  axes  are  at  right  angles  to  one  another  but  are  situated 
in  different  Ijones.  The  most  typical  saddle  joint  of  the  human  body  is  the  carpometacarjial 
articulation  of  the  thumb. 

In  reality  the  motions  in  the  ellipsoidal  and  saddle  joints  are  not  strictly  biaxial,  but  may 
occur  in  any  intervening  axis  between  the  two,  and  one  of  the  two  motions  is  fre(piently  so  lim- 
ited tha;  the  joint  practically  becomes  a  ginglymus. 


t  ! 


3.  POLY  AXIAL  JOINTS. 

The  only  polyaxial  joints  are  those  with  spherical  surfaces,  the  spheroid  joints.  These  are 
sul)di\i(ie(l  into  two  varieties,  the  ,(,'//'//",(,'  /()/'«/s-  or  arthrodia  and  the  ball-nndsockel  joint  or 
eitiirllirosis. 

In  the  at.iirodia  a  spiierical  head  moves  in  a  spherical  socket,  but  the  articulating  surfaces 
are  segments  of  very  large  si)heres,  and  may  seem  in  some  cases  to  be  almost  planes.  Com- 
paratively little  motion  can  take  jilate  between  the  surfaces,  and  what  does  occur  is  more  or 
less  of  a  glidiuL;  ( harai  ler.  (iood  examples  of  arthrodia  are  to  be  seen  Ix'tween  the  articulating 
processes  of  the  vertebra'. 

Ill  the  iiiiirlliroMS  the  arliiulaling  surfaces  are  more  extensive  segments  of  smaller  si>lieres 
and  the  capsular  ligameiMs  are  rtM.niyand  relaxed,  so  tlial  a  considerable  range  of  molion  is 
po^^ible  belwciii  the  two  Ixines.  I'Npical  ixamplt  s  of  these  ball  and  socket  joints  are  to  be 
found  in  the  sho\ilder-joiiit  and  hip-joint. 


SPECIAL  SYNDESMOLOGY. 
JOINTS  AND  LIGAMENTS  OF  THE  VERTEBRAL  COLUMN. 

THE  CONNECTIONS  OF  THE  VERTEBRAL  BODIES. 

Thi  li(Mli(s  of  thi'  true  \irtebra'  are  (  onneiled  by  intenrrlehral  /ilmhiirl!hn;es  ( Kigs.  fj; 
to  1  7S  i,  eai  h  ol  whi(  h  i  Kig,  i  71 )  cunsisis  of  an  exiiTnal  linn  /iliroii^  /-/)/!,'  (  oniposi'd  of  loni  inlrii 
and  interw'MM  bun<lles  of  (onne<ti\c  li^sui',  and  of  a  (antral  gelatinous  or  pulpy  iimliwi,  the 
latter  Iniiig  firnily  compressed  within  the  librous  ring  an<l  JHlwctn  the  adjacent  v(  rlebral  sur 
fate-.  Ml  thai  it  rises  aixiw  iln'  level  of  ,1  hori/unt.il  ni(  (ion  (,f  the  disc,  .\mong  other  substatices 
ll  (oiil.iin-  line  (,trliiai;e  and  liie  leiiiains  of  the  c  iiorda  dor^aiis,  an  emljrvonic  structure'  wiiiih 
imliiaies  the  future  [xisiiion  of  the  vertebral  (i)lumn  and  is  composed  of  a  substance  resembling 


JOINTS   AND  LIGAMENTS   OF  THE  VERTERRAI-   COLUMN. 


U  I 


naec     The  intcrvcncbral  fibrocartila.cs  arc  attache!  to  the  upper  and  lower  surfaces  of 
The  area  .,f  the  intervertebral  fibrocartaa«.orne.h.  ^_  ^^^^^^  ^^^^^^  ^^^^,^.  ^^,^^ 

surfaces  between  which  thev  --'"'1'  Ct  d  r  There  L  no  hbrocartih.Ke  between  the 
against  the  slightly  concave  ^'^'''';^ ^  ^^  ,,e„na  and  third  cervical  vertebne  an.l 
atlas  and  the  axis;  the  first  one  .s  situated  b^^^^^" J^^  "*;  .j,,,^,,^.  ^,,,  ,onse<iucntlv  twentv- 
,,.  last  one  between  the  hfth  lun.bar  ver.  n.  ^^^J,^^^_  .,,,  ,,„..,.  unh  in  cir- 

iodcJlble  in  the  last  one,  which  is  situated   .t  the  promontory. 


THE  INTERVERTEBRAL  ARTICULATIONS. 


-  addition  to  the  mixed  .-'^---;;:; -^X^^^r  ^^^^ 
bra.  also  articulate  with  each  other  by  ^^^^^'^^    ^,^,,^,  ,    Ucular  pn.esses  of  the  over- 
articular  processes  of  a  vertebra  art.culate  ^^'^^^    ^    ';;  ^,,^,  ,„,i,,,a  ,,.  an  articular 
Iving  l.me  <see  page  .,),  and  the  ^'^'f  7?  ^^^^^         Vertebral  region.     There  are  no 
capsule,  which  i>  relaxed  in  the  cervual  -'        ^         '^^,  ,^^.  ,^,„,,,„u.  ..nnection.  of  the 

:z:;;rCei:^rx-^-  '■ 

THE  LIGAMENTS  OF  THE  VERTEBRAL  COLUMN. 

1  „f  .«■„.. roui.--  thosi-  whi.h  run  through- 
The  liganu.nts  ..f  the  vertebral  column  are  con,p...l  o^^^^^K^^^^^^^^^ 

on,  the  en,irc  leng.h  of  the  vcrte,,ml  "-;-;;'      ^.^  J   ^^ );;„„,. ,.,  .,  .hi,h  -here  is  an 
U.uou>  v.rtebra..     Ti.  ,n>t  «":;;;;;;!;,,,;,,;  ,,„„,.„  i,  :,nache,.   ,„  d,e  ant.ior 

:r::;n:,:v!:;r;;Xa:^t;:.erver;ebran^  "-- 

invests  their  posterior  surface-.  .,„i   ,S^)  commence,  al  the  phar^  ivjeal 

U.,..Me  up<.n  the  ba.  of  the  ^Uull  a.  a  ;-■•;;-;;;'  '^XZ^U  uni.cd  t„  .he  inter- 
and  il  terminate,  upon  the  anterm,-  surface  ot  ,lu   sa.n      ■  ^^^^^    ^^^^^.^^_^^  ^^^.  _^^^ 

,,,,,,,,,  ubn.car,ilages,  bu,  i.  -nly  l'"-  >'  -"nc  U.    .        -       -I  J__^^.^^^_,,^_^  ^^,„ 

,he  periosleimi  of  the  bodies  ul  the  vtitii.ia.  an  i 

.hort  deep  ones  which  ,...>  from  one  veM,  bra  to  ^^^']^'-  ,„       „„.    „.,,,i„r  surface 

i;!:,,^::!::;'I:;^trr;;:;;;::•''5:v^^^ 
rri::"::i::;^!''V;:.i;:::;::::::-":;'^"--- - ■ ■"■ 

1,  is  |ikewis.Momposed  of  a  superhual  and  ot  a  Oeep  la>e,. 


I 
I 

S 
J 
I 

I 


j  il 


lj     Ij 
|i    i 


»'i. 


112 

Fig. 

Fic. 

Fir,. 
Fir.. 


ATLAS    AND   TlCXT-nOOK    OF   HIMAN    ANATOMY. 


'7.V 

'74- 
i7.=;- 

170. 


Fi... 

>77- 

Fi... 

■  78. 

Fic. 

i7g. 

Fk;. 

180. 

-The  anterior  longitudinal  ligament  in  the  lower  thorad<   p.^ ion  of  the  vertebral  eolun^n, 

I  tret  her  with  the  ■  osto  vertehral  ligaments  seen  from  in  front  (,). 
The  n  r   t   udinal  h.ament  in  the  lower  tl.-raeie  and  upr^r  h.mhar  portions  of  the 

ver.el.ral  column.     The  vertebral  arehes  have  been  remove<l  ( , ) 

ri.ht  one-,  are  retained  in   their  natural  |.os.tion   (j).  .   ,     ,       ,  .  w... 

-The  pinor  longitudinal  li.ament  an.l  inter..ru.,ral  .lbroeartila.es  o.  the  lumbar  vertebra-, 

the  vertebral  arehes  havini;  been  remove<l  (J). 
-_Mo!;:dh:al  section  taken  at  about  45  -l^'.-s  to  the  me.lian  plane  through  tour  thoraeie 

vertebra-  to  .show  the  eoslo-vertebral  artuulations  (i).  ,         ,    ,  ■„  ,   a\ 

-The  li-iments  of  the  middle  an.l  lower  thoraeie  vertebra-  and  their  nbs.  s.en  from  l.eh  nd        . 
Jr      li^ment,  of  the  middle  and  lower  thoruie  vertebra-  and  t  e.r  nb.  .-en  from  the  U f  1  s.h. 

The  ui.permost  rib  has  been  disarti.  ulale.l  and  remoxed  (}). 


U  widens  opnusite  each  interveriebral  bbroeartila,. ,  .0  wlmh  it  is  firm  y  united,  hut  U  is 

,,,  ,    .:       "nn     ted  ,0  the  l.xlies  of  the  vertebra-,  being  separated  front  them  '-;  v>"-s  plexuses. 

ul.  iti  11  .0  llH.  l..ngi.u.linal  ligaments,  this  group  also  eontains  a  portion  of    he  .«pn^ 

s,iJ:stL.I.      I.   will  be  deseril.d  subse.,uentb  ,  however,  together  w„h  ihe  interspinous 

li.rmu-nis  wiih  whi(  h  il  i>  intimately  ronneeted.  .  ,  ,.      ,,1. 

^     The  short   ligaments  of  the  vertebral  <..lumn.  eonne.ting  e-,n„guous  verlebra-,   an    .ib- 

arehe-  and  th"-e  lonneeting  the  processes. 

'    17(11,  are 


divided  into  tho-^e  connecting  ihi 


'""t  c   iVm.         .lu.  venebral  arches,  the  U.unnU,,  //.n-MFigs.   17.  and   lyb.,  arc 

stron       n  U   e  cmposed  almo.  entirely  of  elastic  ti.sue,  ,0  whi.  h  .he.  o..  ihcn-  pron-iuncc 
Iw  .1  Ik'hc  ihcir  name.     Thev  e.tend  anleiiorly  as  far  a.  du-  po.,  "'-'-J- ; 

ar„.ul.u-  capsule,  of  the   in.ervenebral  ani.ulaiion.  and  -n.^u-ly  <  .;se  ',      u 


I 

With  the  exception  of  a  dislim  I 

1  surface  is  absolutcK   -ni.H.lh  aii.l  i-  dire.ll\   .onlinn.ui> 

lU   their  ela-licity  ihex   keep  .lu   posterior  wall 


llir  artu  ul.i         ,  . 

rinil  .  \cept  a.  th>   siiuaiion  of  the  in.crvcr.ebr.il  loramina. 
^,n„„,  in  .he  me,lian  line,  '.beir  in.ernal  ^urfacv  is  absoluieK 

:;';;:'":;:;:;•:";,;:::::;,  r;,:;!,:.:::.  ."m'-- -  --r  T 

'::'::,■:„;;,,:;:;  ;;;>;.„,  „.,..., -  ■«-"■"  "■■■ '"- >  ■" ' '  -"■ "■ 

III  ••.    l.i-i    -mil  •ire  slroivc-l  below  and  Wcakis.  abo\c. 

'"':;t;:  ::;::«;«.-  '^i-  ■= >  *.»-,„;,.„.,„ „.,  .„..,,,,.  ..».....■ 

,r,„,s,...  Ill    ,lu-   Mrt.l,.-a-.    .!u )    are   par.uularly   dcv.l.ip.-d    ,.,   Uu 


(ni.uding   the   lr,in>ver-e   pr 
|i.,,raii<  and  hunbar  region^. 


..    ._  ..._,   .i.,..,.i, .,,■,,..•■•.!   in   \h.v  liiiubar  region. 

,!„■  y,i[>Msl=iiwlis  //>/»".»/  I  Fig.   1701  whuli  con 


,.|„,.ssc,  (if  1  iinligncni--  verteiir.i' 
Ihev  are  (onlimioii-.  anit  riorlv 


and  aliaiii   on  n 


uiih  .lu-  ligamenl.i  d.ua  and  ] 
lilt  l.  ihe  a| 


Misit  riorh   with 


;:L.  „,  ilu  spinous  processes  and  form,  an  independent  ligamen,.      1  lu    ni.erspinous 


■toMrik 


Anterior  eonio- 
:rim.^vrrsr    <• 
iiliami'tti^ 


Aiitirior 

l()nf;itiiiliitiil 

lii<iinuvt 


liiliivirlilinil  h'l'inii-n 


IlltilspllliUt^ 

lii^iiiiiiiil 


fw.  174 


i<<.  I7'i. 


hilfniiUl'i.i:  lilnonlillhij^i- 


f         I 


hr,i!  /!,■!,  Ii 


I  njiiiiitiiliini  Ihniliil 


mmsmi 


m^s^E^m^^mi^'^ss^ 


m^^^^m 


I   '! 


i, 


Mia^'>:M«i^ 


l.ifrtl- 

ments 

of 
costal 
neck 


Ril's 


W'llchntl  boilv 


Artiaiiiirjaii 


■Is  for  (vstiil  tnl'irdcs 


meiiU: 
flin-d 


Posterior 

Iniiiiiliidimil 
liiianirnt 

ertfbral 
iirrhrs  X 


Fio.  170. 


liUmirliniliir  luHiiniiit 

Intnrtilfhnfl  lor.inun 

I  li^dtiieiit  oj  io^tiii 
nirl< 

Sdcnini 

I'dslrrior 

ivsto- 
rniiisvrrsr 
lii^uiiwnl 


Inr.  177. 


Inlinrrl.hnil 
li/in'i lilt:  lit;'' 


I iiluirti-  I'l  "'' 


11 


yR/^la^'JJS^ 


^       .Si^S 


r 


m 


i  |i 


■  i'      " 


6  I 
1   i 


!: 


S 


iH 


JOINTS   AND   LIGAMENTS   OF   THE  VERTEBRAL   COLUMN. 


'.S 


and  supraspinous  U..n,cnts  a.  found  t^-^^^^^^^ -!;-;;;- ^Llli:!.:"';^  '^X 
cervical  vertebra-  they  forn.  the  n,.»u;^u,n  «m/.MP  g-  ^9;;;"^^,^„  ,,„,,,,,,,,  process 
although  relatively  poorly  developed  m  the  human  sujeU  — n  .^         J^^^^  ^ 

of  the  seventh  cervical  vertebra  (vertebra  l--'^  ^^       f  a  "Iterior  vertical  band  .hich  is 

:::rb^rr;=;i'r:^--n^^^^ 

I  t^ps  of  the  spinous  processes  of  the  remaining  cerv.cal  vertebnc. 

THE  ARTICULATION  OF  THE  SACRUM  AND  COCCYX. 

The  ape.  of  ti™..  and  the  Hr.  ^^^^j^^ ;-;^t:z:rr;:l  r i: "  H^s" 

,v,„/,/n.,W,s-  and  by  a  number  of  relatively  --^'-^''"  /.5;;   ,^    ".j.^"  ,.,),  to  either  side  are 
.;f  .Je'two  Ixmes  is  situate.l  the  anUnor  -"•--;'^- j  ^'     '   i^^^,  j  ,    process    of    t..e 

the   /--'    7-7-"'    ^ZZ  fl'min^T^f  n-1  Lin,  an.l  posuiiorK   there  are 
first  ccK-cygeal  vertebra  and  thcrcb    f"'-"]'"J^  '  ^^  superficial  and  a  deep  one. 

The  ../>../,>•/„/  posterior  sarrocoay,.,!  n,a,un;  ^'^f^^°^^^:^^°^.   ,,,,  ,i,,p  i,„s,rior  s.rro 
coccygeal  cornua,  an.l  closes  m  the  ^'"^Jtcr  port  ^^^^  ^^^^^^.^^  ^^^  ^,^^,  ^^^^^ 

tudinal  ligament. 

T. e... .  .„e ...... ...u.n  .e  .'-^■-■;' ^r '"kC:!::  ^i-^::^:": :::;::;.::! ,:;  ■• :: 

rtn:i^::'r;  ■  ::rr  ::r  ::x.x;:;  •.,.,„..... ... . .,..,.. ..< ...  „, 

of  its  indiviilual  mi,'"ii'i'^. 

The  A«a„,o-oc=ipUa.  and  .he  A..a„.o-«ia.  Articulation.   -J...  ..^>vn,™,._^^ 
,»„!,   a,lan,„-.«ipi.al   am,„la.i,„»   an.l   .1h;   »  l!'"';.''       .■';,,,„„,„,,„  a,,  .«Ti,ii.al 

;::;i:^ :;:::;;::- ;>--'':.;;;::.:  i. ^  a,,,. 


an  art  11  u! 


sur 


n.temblinii;  ^i  cone. 


The  axis  of  rolalinn 


respont 


Is  to  the  long  axis  of  the  otlon 


itoitl  p 


Thi  artit  u 


lition  between  tlie  oi 


Ion 


toid  1' 


Lss  and  the  anterior 


ih  of  the  atliis  i^  a  im\oI 


I  giJ 


'^^^S^-^l^ 


.ML.  M 


\  ( 


11 


IT4 


ATLAS    AND   TEXT-BOOK    OF    HUMAN    ANATOMY. 


Fig.  i8i.— a  frontal  longitudinal  section  of  the  sternum  and  costal  cTtilapes  (J). 

Fig.  182.— a  portion  of  the  occipital  l)onc  together  with  the  atlas  and  axis  (e|)istropheus)  and  their 
lifjamenls  seen  from  behind.  On  the  left  side  the  capsule  of  the  atlantoaxial  articula- 
tion has  been  removed  (,'',,). 

Fig.  iS;.~.\  i)ortion  of  the  occij)ital  bone  touether  with  the  upper  three  cervical  vertebra'  seen  from 
in  front.     The  ca|)sular  li-^aments  have  been  removed  on  the  rijjht  sii'e  (,''„). 


(■trochoid)  ioint  with  incomplete  articular  surfaces,  since  the  oftontoitl  ])rocess  is  frc(|uently 
covered  with  cartilajje  upon  its  anterior  surface  only,  its  posterior  surface  arliculatinj,'  with  the 
transverse  li<;ament  of  the  atlas  by  a  .separate  joint.  Both  joints  have  se])arate  ca])sules;  the 
])osteri()r  one  is  also  regarded  as  a  synovial  bursa. 

The  paircci  lateral  articulations  are  ])ecu!iar  in  that  both  of  the  aiticidatinj,'  surfaces  are 
slightlv  convex,  so  that  during  rest  there  is  only  a  line  of  contact.  The  rotation  ettectcd  by  the 
combined  joints  is  consequently  not  in  one  plane,  but  assumes  a  spiral  character. 


occipiuii  hituf 


Dut'i  mitrr 


Antiriiir  ■inl:  n;  ,:!! 

Aniiruir  ■irlini:  ir  snr/'i'C 
11/  ixloiil  i:J  prorrss 


Odtiiuiiid  friirrs. 
Biiily  iij  iixis 

Iio,l\  <•/  f.rrii-.il 
vcruhri  III 


M>itihr<iH'i  ttclori'i 

Po\ti'nor  itrti'^uLir  slir/:Uf 
o!  odontniti  /)r/<f-rvv 

(   rut  i-ltf  lli^i!llt,)l! 

Kiiiils  III  ccrviC'il  nervrf 


IX I ;  niiiii  bom- 


I'i's.'rrinr  >!ri  1;  n'j  <i:<is 

SpiiUf.s  pr  .(1.^^  oj  'ixia 


Via.   1K4.     A  nil 


,i!ian  lnnffitiMlin;il  s.-dinn  ihrounh  ihc  .itlanto-axial  ailiiulation  (artirukilio  atlocpistroi.hica),  somewhat 


SI  ht'itializi'ii. 


The  capsules  of  the  atlanlo-a.xial  joints  are  roomy  and  relaxed.  The  articulation  is  ])ro- 
vided  with  a  series  of  accessory  lij^'aments  which  elTect  an  extremely  tirm  conncilion  between 
the  head  and  the  first  two  \ertebra'. 

The  Iraiisirrsr  litidiHciit  of  the  atlas  (Fisis.  i86  and  187)  is  .1  very  stronj,'  and  I'lrni  libro- 
cartiia.ninous  iiand  whii  ii  i>  allaihed  lu  ihc  inner  margins  uf  ihc  lateral  masses  of  the  atla-; 
it  i)asses  across  the  spinal  foramen  of  the  atlas  in  a  curved  direction,  the  convexity  being  jjos- 
terior,  and  invests  the  odontoid  jirocess  of  the  a\i>  tdcns  rpistrnphti)  behind.  It  divides  the 
s])inal  foramen  into  two  compartments,  a  small  anterior  one  for  the  reception  of  the  o<lontoi(l 


Jf  ~ 


t! 


CM 

CO 


'    !       1  ' 

I       i  '' 

\V  I  ,3;  3 


-'^''frs 


t 

o 


(J 


/. 


ll' 

P 

.t/. 

r  ( 

^ 

p 

7  "\ 

\^ 

\ 

\ 

\ 

'v 

"S.  ^ 

~^i^ 

^ 

1— 

>. 

■** 

• 

— 

&■• 

& 

& 

^ 

^ 

t: 

'"• 

'^ 

2 

■^ 

"^ 

■f 

■-C 

'  w 

«j 

'>j 

■iiiii 


JOINTS   AND  IJGAIIF.NTS   OF  Till.   VFRTI.HRAI.  COI.IMX. 


r  r: 


process  anrl  a  larger  posterior  one  for  thi'  spinal  cord.  The  i  ortioii  of  tl.e  liuanunt  whirh  i^ 
in  conlaet  with  the  [Kisterioi-  .surfaee  of  the  odontoid  process  is  I'oven'd  with  eartilaf;e  and  there 
is  (usually)  an  articulation  in  this  situation. 

From  the  middle  of  the  transverse  li!,'amenl  of  the  atlas  are  given  off  two  vertical  fa>cicuh', 
one  of  which  jjasses  upward  toward  the  occipital  hone  and  tiie  alianto  occipital  t:'end)rani\ 
wliile  the  other  pa,-ses  downward  and  is  inserted  into  the  jiosterior  surface  of  the  body  of  tlir 
axis  ('epistropheus).  The  combination  of  these  fasciculi  with  the  traiis\er>e  ligament  forms  what 
is  known  as  tlie  crwiiitc  lit^nmciil  '.  Fig.  tS;). 

The  joint  jw^sesvo  tliree  other  ligaments  which  arise  from  the  odontoid  process  of  the  a\i~. 
a  small  weak  rjiiddle  ligament  and  two  strong  lateral  ligamenls.  The  middle  ligann-ni  i-  known 
as  the  apical  odonloid  Ht^iimdil  (Fig.  i8S)  and  runs  from  the  li|)  of  :he  (nlontoid  pnniss  to  the 
nuirgin  of  the  oicipil:'.!  Iv  ne.  I'  is  a  ouite  thin  and  insignificant  structure  and  has  scarcelv  an\ 
mechanical  function.     It  contains  remains  of  the  chorda  dorsalis  (see  page  i  lo). 

The  strong  ligaments  extending  laterally  from  the  (xlontoid  jirocss  are  the  alur  lii^anini/s 
(Fig.  i88),  and  they  i)ass  oljli(|uel\-  upward  toward  the  inner  margins  of  the  londvles  of  the 
(K-cipital  hone.  They  attach  the  (xlonloid  process  to  the  skull  and  act  as  check  ligamenls  for 
the  atlanto  axial  joint.     The  cruciate  ligament  jiartly  covers  them  when  \ieweil  from  behind. 

The  ligaments  arising  from  the  odontoid  jirocess  and  tile  transwrse  liga-iieiii  of  the 
atlas  are  separated  from  the  wrtebral  CMial  by  a  tirm  broad  ligamentous  ma>--.  the  Irdoria! 
membrane  (Fig.  185),  which  forms  a  smooth  surface  exhibiting  in  relief  the  umlerhing  odontoid 
process  and  alar  ligaments.  In  the  skull  it  i-  loiuinuous  with,  the  dura  mater,  and  below  it  i> 
continued  into  the  deeper  layers  of  the  po-tercir  longituiiinal  lig;cment.  It  i>  separate  I  iVoni 
the  atlas  by  a  ])le\us  of  veins. 

.\  further  jieculiarity  of  the  articulation  of  the  lir-,t  two  cer\iral  vertebra'  wilh  the  occinul 
is  furnished  by  the  allanlo-ocrifiital  iobluraior)  invmhraiiis,  which  >rr\e  to  close  the  broad  spate-. 
which  exist  between  the  atlas  and  llu-  occiput.  Tiie  anhrinr  alianto  ocd pilal  labliiralor)  num 
hranc  (Fig.  i8_;;)  fulfils  this  function  upon  the  anterior  surface  of  the  iwo  \-ertebr,e;  it  is  stretched 
bi'tween  the  >ccipital  bone  and  the  anterior  arch  of  the  atlas  and  i>  adherent  to  tlu'  uppiT 
extremity  of  tlv  anterior  longitudinal  liganu'nt. 

The  paslcrior  allanlii-OK ipilal  {obttiralor)  mrmhranr  (iMg.  iS^i  i-  to  be  reuanlid  as  reiire- 
scnting  the  uppermost  jKirtion  of  the  ligamenta  llava,  although  il  ha>  not  the  ela-:ir  slructun- 
ot  the  latter  li  ^anient,  and  is  much  thinner.  It  closes  in  the  sjiace  liei"ven  the  occiput  and  the 
posterior  anh  if  the  atlas,  le;i\ing  apertures  for  the  jiassage  of  ves>rl>  ,  nd  nerve>,  and  is  con 
tinned  in  thi'  interspace  between  the  atlas  and  axis,  taking  the  plate  of  the  first  ligamentum 
tlavvuu. 


In  tli<-  atlant(i-oriipii;il  :\rtiiul.->tion  tliiTc  i-;  |irMilii;illy  no  nicninirnl  |HTmiai-rl  .\\vm\.  ili.  -liurt  N.i^iii.ii  .i\i,,  liiii 
till'  I  liicf  riiiivrmiTit  o(  rurs  about  tlic  liiiri.^ont.il  and  tr.in^vcrsi-  axis  am!  i  ■moists  of  tln'  nml.ii        iiinvrnirnl-  ..I  llu   !u nl 

In  the  atlanlii-axi.ii  arli.  uiali.in  ihc  ac  lual  mtatinn  nf  the  lu;ul  ..nurs  .il>.mt  a  Mili  a\U  |ia~-in>;  il".nii;!i  llu- 
r«!i.lii,.i,i  |.i.Ki>.^  oi  liii-  aM>.  'I'mi'  main  juitii  ail-,  a^  a  jiuiii-juinl,  inn  liic-  nualion  i-  i  hi.  i  hy  tne  alar  liganHau^  and 
aniuuiils  to  .diout  40  dcKm,  uidy  in  lai  h  dim  licm;  the'  laturai  jrnnts  allow  nf  a  ^jiiral  niotiun. 


■.i.  ■ 


tt6 


ATLAS    AND    TKXTIiOOK    OK    HtMAN    ANATOMY. 


Fk;.  1.S5,— The  lertoriul  membrane  seen  from  behiiKi.  The  |K)^terior  portion  of  llie  oetipital  bone  and 
the  arches  of  the  three  ujijier  cervical  verleljra'  iia\ebeen  rennned,  as  well  as  the  cap- 
sular ligaments  of  the  rii;ht  side  ({'„). 

Flc.  iSf).— The  atianlo-iHlonloiil  articulation.  The  odontoid  process  (iAhv  cpistrophi-i)  and  the  ankrior 
arch  of  the  alias  have  been  cut  (,",,1. 

Flc.  1.S7.— The  cruciate  li|,Mment  after  removal  of  llie  icitoriai  membrane.  Tlie  articular  lapsuli--  have 
also  been  removed  on  the  ritiht  >ide  (-,'',5). 

Fk;.  iSS.  'Flu-  alar  liu'amenl-  after  removal  of  the  cruciate  liirament.  'Fhe  articular  cap^ule^  as  in  the 
lirecedini;  l'i,i;ure  ( y',,  I. 


THE  ARTICULATIONS  OF  THE  RIBS  WITH  THE  VERTEBRAL  COLLTMN  AND  WITH  THE 

STERNUM. 

The  posterior  extrePiilies  of  the  rilis  an-  connected  with  the  thoracic  vertchne  by  arthrodial 
joint-  iFigs.  172.  1 ;(),  and  17.S  to  180);  their  anterior  extremities  (Ki.i,'.  181)  articulate  with  the 
sternum  or  with  each  other  by  means  of  either  arthrcMJial  joints  or  synchondroses.  The  anterior 
extremities  of  the  Iwo  lowermost  ribs  are  not  attached  to  any  portion  of  the  skeleton. 

The  ribs  are  (oniiecled  to  the  vertebrtL'  t)\  a  (loid)le  arlii  ula'M:).  The  head  of  each  rib 
articulates  with  the  iKwiies  of  two  adjacent  vertebra-  (the  e.xccptions  are  {;i\en  U])()n  pa>;e  '(>)  and 
the  tubercles  of  the  ribs,  with  the  exception  of  the  last  two  (-.ee  paj;e  J71,  articulate  with  the 
transverse  ])rocesses. 

'File  arlictdaliuns  of  ihe  luads  of  the  riljs,  with  the  excei)tion  of  the  uppermost  and  the  two 
lowermost,  ail  ^  haracteri/.ed  by  the  fact  that  the  intervertebral  librocartilage  between  the  two 
vertebne  forminj,'  the  articular  cavities  is  continued,  as  the  iiilirartidiliir  lii^nmiiil  (Fij;.  17S), 
as  far  a-  the  (rest  upon  the  heail  of  the  rib,  and  divides  the  arlic  idalion  into  two  ( omiiartments. 
The  weak  articular  capsules  are  reinforced  by  ihe  niitlalr  (stilluli  ]  lif^,iitiiiils  (Fiiis.  172  and  iHo), 
which  arise  from  the  head  of  the  rib  and  radiate  to  the  lateral  surfaci's  of  t!ie  IxKlies  of  the 
V(  rtebra'  forniinn  the  aniculation. 

'Flu  i()\lo  Iriiii^Virsi  iirliailiilioiis  havi-  lajiacious  (ajisules  and  are  cliarac  teri/.ed  by  ikis.hss 
ini;  i|iule  a  luimlKT  of  reinfon  inf.;  or  c  lui  k  ligaments.     'Fhe  posli  lior  surface  of  the  ca))sule  is 
ninforccci  bv  a  -hort  tense  lig.sment,  the  lii;am(iil  aj  llu  (oslnl  luhinlr  ipuslrtior  a-slo  Innis-irrsc 
lii^iimiiil]  (Fig.  17c)),  which  is  app|-oxiiiiately  (|iiadratigular  and  composed  of  ])ara!lel  t'jbcr-,  and 
c  xteiicls  outward  and  slitrhtlv  upward  from  tin  lip  of  the  iraiibVerse  |)roiesN  to  the  posterior  sur 
face  of   the  neck  of  llie  arlic  ulaliiig  lib. 

'Fhe  lii;iim(iil  oj  llir  iinl.'  imiddh  ' <ni,i  /n/)/v;vr?c  or  iiilrrossioii.'i  lii^ami)!!)  (Fig.  17S)  almost 
ccimpletelv  t'lIK  ihe  s]iacf  between  the  neck  of  ihe  rib  and  the  transverse  proiess  of  the  thoracic 
Vertebra.  Il  i-  hori/onlal  and  passes  from  llu-  anurior  surface  of  the  transverse  process  of  ihe 
vericliru  lo  llu  posterior  surface  of  the  neck  cif  the  rib.  'Fhe  kisIo  Iniiisfrrsi  {sufurinr  w^lo- 
trdinvirKi)  lii^amrii!^  run  between  the  po'-te-rior  extrc-miiicv  cif  the  ribs  and  the  iransverse  jinn- 
esse-,  anil  eae  li  mav  be  regarded  a-  coiisi-ling  of  an  iiittirior  ancl  a  fioslcrior  losln  Iniii^vtrsi  lii^a- 
nil  III,  iMith  of  which  ]nirsue  ;i  similar  course  from  the  net  k  of  the  rib  to  the  transverse  process 
of  the  overlying  vertebra.  'F'lu-  anterior  ligament  (Fig-.  1  7<i  and  iH^i  i-  tolerably  -iroiig  and 
apiiroximalely  rhoml«)id  in  shape;    it  pasx  -  from  the  lower  margin  of  the  transver-e    process 


Oiripila/  Inuir 
/iron's'' 


Arliiiiliir 
tiiii^iili"' 


Triiiisvnse  pivrrxs 
of  trivicol  viil.  Ill 


Mi'iiihiiiiui  li'iloriii 
/■(ir.   1ST. 


Mar 
l/i'iiiiii  iil^ 


\rti(iihir 
aipsiilr       ^  - 


('riiiiiih'  lii;itnirtil 
(■•ii/xrit'r  !uiih) 

l!ii-.i/{ir  porlioii  ,if 
<>i('ipil<il  ht'iir 


Spinoii'i  prof 
of  tixi^ 


I  niiisyiTsi 

li^iitiirnlof 

iitliis 


.\rfiiiiliir  iii/i'-liirs 


fl!'    hSS. 


,in.l  r;,,^ 


-  .> 

[y^ 

ivT: 

"1 

9 

—  -^ 

[ll_KL 

^m 

()il(iilloiil  /iron  ■• 


Itihlv    Ol    II  MS 


i^i^ 


I 


Tin:    ARTIcn.ATIONS    AM)    IICAMINTS    OK   TUV.    IIKAH. 


117 


and  frequently  also  from  llie  lower  bonier  of  tlu'  a.ijacent  rib  to  the  neek  of  the  next  lower  rib. 
The  jiosterior  li,i,'ament  (Fiir.  ,7,,)  is  niueh  weaker  than  the  anteriir  one;  it  i>  trian-ular  in  shape 
an<l  runs  from  the  base  of  the  transverse  j.roeess  (or  ai-o  from  llu'  articular  ,.nHeC.>  to  the  pos- 
terior surface  of  the  nrek  of  the  next  lower  rii,.  The  two  li,iran,ents  form  the  l.oun.lari. .  of  an 
opemnu,  the  coslo-tniii.sirr.u-  jor.imcn,  whieh  -ives  -'assa-e  to  the  intercostal  branch  of  the  spinal 
ner\e. 


The  m-.voment.  of  (li,.  ril,s  upon  th.-  v,Tt,-l,m-  arr  .onsi.l.T.il.lv  lin,i..-.l  l,v  ih.-  -urroun.li.u.  ,  !„■,  k  lii-anunt-.  Thr 
iwo  jo,„,s,  that  of  .1,.-  h..a,l  a„,l  ,ha.  of  ,1„.  lulnn  I.-,  a,,  ,o«,,l„..  a.  a  ,  nn,l.,  .,1  ar.i,  „lal,o„  u  I,,,  1,  ,„,nak,..  „f  ,1„.„  „ur,. 
of  a  Pivot  joinl,  uhos..  axis  corrrspomis  to  ,h,.  ,„■,  k  oi  tlu-  ni,  an,l  i.  ih.-rrfon-  ahno-.  iransv,,,,..  Tlu-  nmumnn  ,l,out 
tills  axis  .s  sue  h  that  thr  anKTior  .■«niniii.-s  r,f  the  ril.s  an-  ,kvatr,l,  and  the  ,h.lan.  <■  I,,  t^^r,„  their  anlrn. 
and  tl'.e  vrrtiliral  column  is  in,  reascil. 


nor  rxtnniitics 


Tl.  '  cartilai;es  are  connecterj   with  the  sternum  partly  In    svni  liondro^c  ,  and   partl\ 

by  mov  Is,  the  sIrnw-rosUi!  arlini/.Hions  (Kifr.  ,81).     The  first  costal  lartila-c  is  always 

united  to  ,R  sternum  by  a  sent  hondrosis,  biU  l«l«een  the  anterior  cMninili.s  ,,rilu-  second 
to  the  sevei.dl  costal  cartilages  and  the  sternum,  however,  there  are  usuallv  true  join.s.  The 
second  sternocostal  articulati.,n  (and  fr(<|ucnllv  the  remaining  ones)  alwavs  contains  an  inirr 
arluuhir  li^amnit  (Fit;.  ,S,)  whi.l,  passes  from  die  synchondro.sis  betwtrn'the  manubrium  and 
tlu  iMHly  of  the  sternum,  ,.r  from  thr  outer  mar-in  of  the  bodv,  to  the  anterior  extremilv  of  the 
costal  eartila-e  an.l  divides  the  joint  into  two  compartments.  This  li-ument  is  inonstant  in 
the  articulati.ms  of  the  thinl  to  the  s,  vt„ih  tuMal  cartila-es  with  the  .sternal  b.,rder,  and  wh.n 
It  IS  present  it  is  fre(|uently  so  siiualed  that  the  articulation  is  une<|uall\  suMiv  i.led. 

The  anterior  surfatvs  .,f  the  articidar  capsul.s  of  the  sternocostal  articulations  are  rein 
forced  by  the  rmlhUr  lif;,„nnils  (Fi^-.  u)2)  which  arise  from  the  ends  of  the  costal  cartilai^es  and 
spread  out  like  fans  up<.n  ihe  anterior  surface  of  the  sternum.  The  interlai  ini;  fibers  of  the 
radiate  lif,'aments  of  the  lower  tartilages  form  a  m.-mbrane,  the  sUrual  nnmhnni,;  up,,,,  ,l,e 
anterior  surfa.v  of  the  lower  pinion  of  He  sternum,  and  are  blended  uiih  the  peri,.steum  in 
this  silualion. 

Joints,  whi.  h  are  known  a.s  the  inhnlu  „  lr.,1  i„i„ls,  maN  also  be  present  between  the  tosid 
carlila-es  of  the  fifth  to  the  tenth  rib^  (see  p  ;e  ,5,^1,  an.l  in  the  >1.  rimm  ilself  there  is  a  sl,r„„l 
syiirliniidrosis  fsee  pa^e  vD  between  the  mam:  )rium  and  IkkIv  which  frc,|uenll\  ha>  a 
cavity,  and  s<mietimes  also  a  svnt  hondrosis  b,      ten  the  bo.l\  and  the  \ipli,.i,|  pro.ess. 

The  inlrno  '   '  /,>,»„„/.  ai.   rtallv   mtxlil.    j  fastia'  whieh  uill  i,e  uMi^dered  in  the  d.-t  rip 
tion  of  the  mus(  les  (see  ]iHf^v  Kii;). 


an  artitular 


'Tlu-  a.  Iiiai  rannf  oi  inoimn  ..|  \\\r  ,  osial  ..iriilaK.  >  I"  ih.- 
Hirlrrahlv  iiii  ri'.isrd  liv  Ihi-  rla~liiilv  of  ihi-  .  .iriil.ii;.  ,  ihinis  vi- 
ail  simullamously  ami  in  ihi-  Mnii-  manm  r. 


■-Iirno,o,|al  aril,  ul  ,1101,,  ,,  ,|, III,    innii,  ,1,  hui  ii  jsmn- 
Ihe  cosi,„,rli  l.r.d  .md  lli,-  ,  osi,,.i,rnal  aril,  nl.iiion. 


THE  ARTICUlAnONS  AND  LIGAMENTS  OF  THE  HEAD. 

Tl  .•  onlv  movable  joint  bt  Iween  the  b.,n.s  uf  the  h  ,   I  is  th,  1,  nip,M,.  masillarv  articulation. 
The  remiiininK  Ix'nes  are  unile,l  by  sutures,  the  termiii(,|,)ny  of  \vhi,h  l...s  alrea-h  been  discuss,,! 


m 


lif 


ii8 


ATl.AS    AM)    TEXT-BOOK    OF    HUMAN    ANATOMY. 


Fic.  189. — The  right  tompnro  manclihukir  articulation  seen  from  the  outer  side  (]) 
Fk;.  igo. — The  rijiht  tempuro-mandiljular  articulation  seen  from  the  inner  side  (', ). 
Fii;.   in.  The  rii^ht  temporo  mandibular  articulation  opened  hv  a   sagittal   section, 
arWi  iias  been  removed  (\). 


The  zygomatic 


n 


in  the  sect. on  ujKJn  osteoloj^y.  Considerable  quantities  of  connectixe  tissue  are  found  onlv  in 
the  s])henopetn)sal  fissure,  in  the  foramen  huerum,  and  in  the  ])elr() occipital  fissure  {sphcno- 
petrosal  and  pciro  occ  ipilnl  synchondroses). 

THE  TEMPOROMANDIBULAR  ARTICULAnON. 

The  temporomandibular  articulation  iFigs.  i8(;  to  iqi  )  is  the  joint  Ix'twcen  the  condyloid 
tircKcss  of  (he  mandible  and  the  nnuulihular  jossa  of  the-  tem](oral  bone.  It  is  completely 
sulxliyidcd  into  an  U])])er  and  a  lower  portion  by  an  oblong,  biconcaye  urlkuUir  disc  (Fig.  i()i), 
which  is  adherent  to  the  capsular  ligament  by  its  circum*'erence.  The  two  joints  which  are  thus 
formed,  namely,  that  belwei'n  the  mandible  and  the  disc  and  that  between  the  disc  and 
the  mandibular  fossa,  act  separately. 

'Fhe  articular  capsule  of  the  joint  iF'ig.  \q\)  is  rather  thin  and  relaxed.  It  embraces  the 
mandibular  fossa  as  far  as  its  posterior  non  cartilaginous  surface,  the  articular  eminence,  and 
the  head  of  the  condyloid  process,  and  i>  insertecl  into  tlie  neck  of  the  mandible.  Its  external 
surface  is  reinforced  by  a  ligamc  nt  jiassing  from  the  zvgoma  to  the  neck  of  the  condyloid  process, 
the  Umporomtuidihular  l<:\t,riiiil  h.Urah  lif^amrnl  (F"ig.  iSiji,  ;ind  it--  Jilxrs  ]ia^>  from  abo\c- 
downward  and  from  before  backward. 

In  tli(  11  ni]i"r"ni.inililn;I.ir  anil  ul.iiion  llu'  -"iki  1  i^  fdTiiK.l  [Mrllv  l.>  ill.  ;ii.ini!il>iil.ir  fn.„.i  and  |>arll\  l.\  \\\v 
anil  iilar  rinimn.  1 ,  and  n\i  r  llir  lalli  r  an  a|i|iri>\inialrly  cinirruinl  surfai  r  im  !'•>  luad  of  tin  ,ond\  ii  i-  I'nrnud  l.\  llic 
artii  ular  di-i .     Tin  two  ii  in|)or>>ni.ind)luil.ci-  ar!i(  ul  iliun^  a.  I  sinwillaninu-li 

Will-  ilu-  inc.ulli  iv  i>|.,iird  ill.  Iliad  nl  llu  imidvlc  nilh  llic  inirrarlii  u'ar  di>i  Kliilr-.  fnrwanl  Uimn  iliv  irtiiular 
I  mini  111  1 .  and  wlnn  ilh-  nmulli  i,  .  IumiI  it  -liii^  hai  k  into  1  n  ni.imlilmlar  lus-.i.  llu-  np,  ninj?  and  1  jn^inn  of  llic-  nioiilli 
arc  (iinMiiucnllv  aiii  nr|i-d  by  a  vjidint;  uf  ihr  niaiidililc  (.1  niidinK  j"inii. 

In  aildiliiin  t..  lhi>  rntidilud  fnrni  of  liinnf  inimnu  ill.  llu  .irlii  iilalinn  |.iivMv-.r^  a  -i  1  mid  kii  d  ■■!"  mntinn.  ilv  laliral 
i|i-|i|.iirnii  nt  lit  I  111  niandilili  in  n  fi  rrnn-  li.  the-  >ku'il.  In  ihi^  1111  i\i  nn  111  niu  inndvluid  In  ad  h  main-,  in  llu-  maiidiliulai 
'iK-,!  uliiii-  ilir  ulli.  T  aiKani  1  -  uimn  llu  ariii  ular  1  mini  m  1 ,  1  innviriunl  uliii  hi-  ■'  iii,s,i!,|i-  \(  h,  n  th,-  mnulli  i-  ii|  mud 
tit  Its  ^naU--t  (Ntcnl,      linlh  tlii'  liin^r  and  llu-  laur.il  miivi  nu  ni>  arr  iniiiliiiud  in     ir  .u  I  nt  nia-lii  alum 


INDEPENDENT  LIGAMENTS  IN  THE  HEAD. 

In  the  vicinity  of  the  lemporoma\illary  articulation,  but  without  .in\  direct  cimneclion 
with  tile  joint,  are  situated  two  liganii  ills,  the  spheaomanclibular  ligament  (i''ig.  ii»oi  and  the 
-tvlomandibular  ligament  (!''igs.  ie;i  and  ic)2).  Tin  ^pluiwimiiulilnihir  linaiiuiU  arises 
I'roni  the  under  surface-  of  the  greater  wing  of  tlie  splic-noicl  Ixine  near  il«  spine  and  is 
inserted  into  thi  lingula  of  llie  mandilile.  The  styloiiuitulihiihir  Hi^nmoil  takes  origin 
from  the  styloid  jirocess,  which  i-  freciuentl}  embedded  in  the  ligament  for  some  distance, 
nrui  ji.Ts^is  til  trii  inner  suriaic  cd  liu-  .iugK-  uf  iJu-  jaw.  Rulh  iig,iiiieiil>  ,iic  \m-:iIs  and 
resemble  fasc  i.i',  and  thi^  i^  partic  iilarlv  true  of  the  stylomandibular  ligament,  wliiil.  radiates 
(lircelh  into  the  fu.seia  of  the  internal  pterygoid  muscle  (bimtipharyngcal  fascia,  see  page  184J. 


i 


iimiioivm  iintilnihir  Ui^nninil 

/\Xt"ihitic  inch 

I 


/a  t'T/Ull 

iiiuliti'iy 
meatus 


Miisloiil  /innrss 


Sivloiiiciiiili'/iiiliir  lii^amfiit 


(OllilvltVtl 

ItroiTss 


t-ii'.  ISO. 


Arliniliir  iiiiiiiiihi- 


h'lii/itirii/ 
lii'iii' 


I'lliyLilUll  /l^ll(■|'^^ 

SpllOIOK/   llOlli' 


liiiipoidl  hoiii' 
SpUiiu'iiiiiiiili- 
hiihir  lii^iiiiiciil 


/\i^i)miili(' 
hiiiif 


.\itliiiliir  (ii/i''il/r 

Artitiiliir  ilisf 


(   iHlHWill   /)/l>i(  >s 

fin.   l»l. 


I IV.  I'H). 


!h 


H 


.:'^..-:|,;5S7^':i^;,5^^;1 


•T    * 


<^y7..^^4^ 


'mm-.^^^- 


THK   JOINTS   AND    I.U.AMF.NTS    OF   THE    UPPER    EXTRKMITY. 


liq 


In  addition  to  these  structures,  the  head  possesses  another  indq)endent  hf;ament,  the  {>trry- 
aospimus  ligament,  which  passes  fr.,m  the  spine  of  the  sphenoid  Ix.ne  to  the  upper  extremUy 
of  the  outer  plate  ol  the  pter>f.oid  process.  Sometimes  this  ligament  l)ecomes  oss.hed,  and  it 
then  forms  tlie  ptery^ospinous  process  (Civinini). 

THE  LIGAMENTS  OF  THE  HYOID  BONE. 

The  Rreatcr  comua  of  the  hvoi.l  are  connected  with  the  Ixxly  of  the  h.nc  either  bv  movable 
joints  or  bv  svnchon.lroses,  or  they  arc  united  by  synostoses.  The  lesser  cornua  are  fre(|uently 
cartilaginous  and  are  connectc.l  to  the  Ixxly  by  movable  joints  or  bv  syndesmoses. 

Kach  lesser  cornu  is  connected  to  the  styloid  process  of  the  tem|.oral  Ix.ne  by  the  slylohyonl 
liganunt. 


\  iKirtion  t'\  lln'  li'sscr  cornu. 


,r   1  r..a  of  .  irtilni;.-  noi  .onncdc.l  th  thi-  tn-ni,l  lKim.  somolini.  ,  .•NtotiHs  im..  ibi- 

.,vl„hv„i,l  li,:>,.cnt,  an.l  in  a  similar  n,anncr  .lu-  stvlo„i  pn„«s  .,r  .,  .,  mM  t».ny  spuuU-  may  .vu,.!  '^^^^^^^J^^ 

mon.;    Al,  U,u.-  ,«,r>i,ms,  the  k-sscr  ...rnu,  the  s,yl,.hy.,ul  liKam.nl,  au.  .h.  stylo,.l  ,,r.K,.s.,.  hav.  a  ,..„„„on  or,«,n  ,„ 
thf  si<cini!  vi.-n'ral  arih. 


IE       i 

f       1 


THE  JOINTS  AND  LIGAMENTS  OF  THE  UPPER  EXTREMITY. 
THE  SiERNOCLAVICULAR  ARTIOH-ATION. 

The  sternoclavicular  articulation  ( Kif,'.  u)2)  is  the  joint  between  the  clavicular  not(h  and 
the  sternal  articular  surface  of  the  clavicle.  The  two  arliculatin-  surfaces  are  incn^iruent, 
but  thev  are  adai.te.l  ti.  ea.  h  other  bv  the  interposition  of  an  arti.ular  <iiM  ,  whuii  divides  ihe 
articulation  int.,  two  completely  separated  cavities,  the  articulation  in  this  respect  rex  niblm- 
the  temporomandibular  joint.     The  ed-es  of  die  disc ,  the  inner  one  in  particular,  are  M.m.wliat 

thickened.  .  ■•••.-        i 

The  •irticular  capsule  i^  thin  and  rclaxe.l,  but,  c^xcvpl  "n  its  inferior  pcrli-.n,  U  is  reml-.rced 
upon  ill  sides  bv  sironj:  liKaments.  The  mc.st  striking  <.f  these  is  the  sUrno, lav,  uhr  li^am.nt. 
which  is  adherent  t<.  the  anterior  surlace  of  the  capsuU'.  The  hiUrdaviau.n  Ir^.m.  nl  is  a  sint^le 
li-Mment  which  passers  a.  n.ss  the  jiiRular  nolcl,  al  the  ui)l>er  mar-in  nl  tlu^  sternum  and  en 
ne(t>  the  sternal  ends  of  Ixith  clavicles,  tlnis  reinforcing'  the  upper  pcrtinns  c,f  die  ca|.sule>  ol 
bciili  ■.tenvHlavicular  articulations. 

llu'  a>slo<t.ivinil,ir  [rhomhoid\  li^^,nur,il  i-,  exceedingly  slrc,n.^,  and  altlvni-h  really  an  incle- 
pendenl  ligament  it  belonf;s  In.m  the  functional  standpoint  to  the  Mcrnoclavic  uiar  articulation. 
It  extends  between  the  carlilaue  of  the  lirst  rib  and  the'  costal  tubcrn>iix  ol  die  .  l.nicie .  and 
almcsl  completelv  fills  the  s,,a<T  bctwcrn  the  sternal  end  of  the  claNi.le  and  llu-  lir^t  nb.  lis 
fibers  are  ralher'short  and  become  tense  when  liie  clavicle  is  but  sliglul)  aUlucted  from  the 
thorax. 

Tlv.  .„.rn,«l:.vi,,.lar  arliculalion  is  an  ar.!M„.i.al  join,  ,in,l  ils  ran*;.-  ..(  mo.inn  cv.ml.l  I..   ,|L.itr  .nn.ia.ral.l,-  «■  r.- 

i,  n.,t  for  th.-  n-inf„r.M,K  liKam.n.s,  |urli,ularly  ,!„  ,  .M.„  l..v„  ular  hRannni.  «  m.  n  unu,.  ,.    u..r,  ,....  ,n,„k,..  ,l.g,..^ 

Slii,;  m,„i.m  .,f  ,he.  .lavi.l..  i-  ...... mpaniv.l  l.v  a  ,.r.,n„un,e.l  movenun.  ,.(  ,lu  ,.a,,ula.  .n.-  ih.   ,lau.l..  R.-ncrally  a,  ,s 

as  a  livcT  f.ir  the-  latu  r  Ixmc. 


Bb.  1 


Mi 


'-A: 


. '    -  .,'-;-  \   '  ,^„ 


'1  ■,  -.  .  - 


*-  _r  r  -  ■ .' '^ '-  "III' 


ill 


}    i 


H 


120 


Fic.    iq2. — The 


Fk; 

I'lC. 


ri(. 
Fk. 
Fl(. 


ig?. — The 
104.  —The 

105. —  I'he 
106.— The 
11)7-     A  fn 


ATI.AS    AND    TKXT-HOOK    OF    I.JMAN    ANATOMY. 

two  sternoclavicular  joints,  tocjether  with  the  lostostcrnal  articulations  of  the  two  upj)cr 
ribs,  seen  from  in  front.  The  right  sternoelaviiular  joint  has  heen  opened  by  a 
satrittal  section  (i). 

left  shoulder  and  acromiocla\  icular  joints  seen  from  above  and  from  the  inner  surface  (J), 
left  shoulder-joint  seen  fmni  behind,  the  Ion};  head  of  the  tri  eps  being  cut  and 
the  terminal  jiortions  of  the  suprasi)inalus,  infras])inatus,  and  teres  minor  muscles  cut 
;;nd  turned  outward  {'i). 

left    shoulder-joint   seen    from   behind   and   above.     The   acromion   process   has   been 
removed,  and  ihe  nei.uhborinj;  muscles  treated  as  in  the  preceding  t'li^ure  (}). 
socket  of  the  left         ilder-joint  after  removal  of  the  articular  capsule  and  the  tendon  of 
the  biceps  muscle  ii). 

)nlal  longitudinal  section  of  the  shoulder-joint,  parallel  to  the  tendon  of  the  long  head  of 
the   biceps   (  j ). 


THE  ACROMIOCLAViaJLAR  ARTICULATION. 

The  acrominc/d-  •  uUir  arl'u  illation  (Figs,  u),:;,  IQ4,  and  i(>6)  is  the  joint  between  the  acromial 
articuhir  surface  ol  .  lavicle  and  the  acromial  articular  surface  of  the  sca])ula,  and  it  conse- 

(juciitlv  forms  th.'  connection  between  ihi  two  com])()nenls  of  the  shoulder  girdle.  The  articu- 
lation ma\  contain  an  articular  (li>c,  but  it  is  small  anrl  \aries  greatly  in  the  degree  of  its  develo])- 
menl;  it  is  frerjuently  incomijjete  and  often  entirely  absent.  The  up]ier  iwilion  of  the  articular 
ca])sule  is  the  strongest,  and  i.-  still  further  reinforced  by  the  acnimUiclaviitilar  lii^aiiunl  (Figs. 
1CJ4  and  J0),  which  connects  the  bones  forming  the  articulation. 

.\  >trong  ligan-.entous  connection  between  the  acromial  end  of  the  clavicle  and  the  scai)ula 
is  elTecteil  1)\  the  loractulavkuhir  Hi^tinunl  (Figs.  11)3  and  h)(i),  which  passes  from  the  upi)er 
surface  of  the  base  of  the  coracoid  process  to  the  coracoid  tuberosity  of  the  clavicle.  The  liga- 
ment is  comi)ose(l  of  two  jjarts,  an  anterior  tlat  cpiadrangiilar  portion,  known  as  the  trapezoid 
lif^amntt,  and  a  ]H)sterior  triangular  one,  broad  above  and  narrow  below,  the  (())((;;'(/  linamrnt. 
Between  the  two  the  siibclavius  muscle  is  inserted. 

'\'\v  ;iinmiic>ilavicul;ir  urtiiul.iiioTi  ha^  hul  3.  slight  T:\n\ic  of  motion.  Thi'  roracoclavicular  lig.imont  acts  as  a 
chcik  ligamiTil,  jii^l  a<  \hv  .  ii!,ioi  lavii  iil.ir  IJKaniinl  dcK-s  in  llii-  sli-rniKlavicular  articulation.  Thf  relative-  position  of 
tin-  two  Ixmc-s,  i.in  -,  .irtcly  Ik  i  handed  voluntarily,  Imt  pa^sivi-  tnovrTin-nts,  prmlui  in^  a  <  liange  in  llif  angle  lic-twrtn 
the  two  Ume^,  ell .,  oc  i  ur.  The  -niall,  imlistim  tly  Imumleil,  and  usually  ll.il  articular  surfaces  allow  of  a  liisplannienl 
of  the  two  hones,  hut  llse  direction  of  the  movenitnt  is  not  determined  hy  the-  slwpe  of  llu-  articular  facets. 


THE  LIGAMENTS  OF  THE  SCAPULA. 

There  are  three  ligaments  attached  to  the  scajuda  i  Figs.  \i)\,  rc)^,  and  i()6)  which  do  not 
luiong  to  any  of  the  neighlKiring  joints.  These  are  the  loracoacromiai  lif^amrnl,  the  superior 
transverse  lif^aweul.  and  the  injerior  transverse  lii^ament. 

The  KiraniiK romial  lii^ament  (F'igs.  u)^,  it)4,  and  it)6l  is  a  llal,  tense,  strong  ligament  whit  h 
connects  the  anterior  margin  of  the  acromion  with  the  posterior  surface  ot  the  anterior  e.Mremity 
of  the  coracoid  pnx  ess.     It  is  situated  immediately  alxive  the  shoulder  joint. 

The  superior  Innisi'erse  /ii;ameut  ( Figs.  193  and  \>)^)  is  a  shor',  tense  ligament  which  bridges 


j»«t 


Articnhir  i\i/)siili 
(AKiitl  nirtilii!;!'  I 


(A^stiiiliiviitiliir 
limiiiifiil 


Miiiiiiliriiiiii 


Si f mil/  sYiichoiiilrosi-i 


C.ldvicli 


ConiU'Cliiv  iiiliir  lii^iimeiit 
il'onoiit  /lorticii) 
Siipiiior  tninsnrsc  ligiiniait 


SliTiioiliiviiiihir  lii^iiiiicnt 
Riiiliiilc  sliiiiiKv^/ii/  //;'• 

/•Vi,'-.  102. 
C.ostiil  iiirti/(i!Si'  II 


C.onuoiliiviciildi-  /ifTii/iti'iit  (  fni/iiZ(>itl  /iciiiiiiii) 
Connviil  /inurss 

(AViiiV-(irn)iiii(i/  lif^diiieiit 

Acromion 


liitiiliibciriiliir  miuoiis 
••liidl/i 

Snl'^i'o/iii/iins 


I  t'tii;  hiiiil  01  biii/i^ 


.  Ji 


/  /<^  103. 


*^ 


/fj-; 


AiroiniocUiviiiiiiir  ligament 
('oriiiv-nnvniinl  lii;(imi'iit 
Siipnispiiintii> 


Infriispiiititiis 


Amimioi! 


Ti'irs  minor 


H II nil  I  IIS 


Spinr  ('/  scd/'iiiii 


F-'i''    104. 


V. 


'  ;i 


Mi 


Sii/iriis/iiiiiitiis 


liifnispiiHitii^ 


Siipcrwr  trctiy'Virsc  lii^iinunt      Spine  of  ^iiipiild 
Cormoid  prociss  y"^ 


Connvhiimrral  !ii:iiii!nit 


/ins  iiiiiior 


l.onfT  hi-iid     /loaw.nt  ^v     ' 

of  triiips  \ 


ti^.  105. 


I » 


Clttviilf 


1 1  •ape'.  ■  ii  !U"  twnt 


Anvmh<,l(ivinili}r  lii'diiu  nt 


\/r,viiJO/l 


('ortiivi/,:.  iiiilar  /ii^iiiiii/it  (C.oiwitl  /nirlio/ij 


C.ordcviil  /'ivnss 
Coniio-atiomiul  /igami in 
I  union  of  lorii^  liriiil  of  hiirp 


(i/iih'idiil  lip 


//''.  lOh 


I  out;   liCdil  of  trinps 


('oiiK 


ConuohiiiiiiTiil  li''iiiii( 


hittidihriailiir  iiiikoiis   slirnth 


-/■...J...    ,/■  / I.  ...I    ,*■  /,.*  — 

r  r  .'.•[IC:.'     ','     ft".':,*     •••r.-'f    fj;     r-."r/-~ 


ii\  ItV 


■  i 


|l  f  I 
|i    '  I ; 


t  I    i 


i^' 


"Svi 


Tin:   JOINTS   AND    I.KIAMFNTS   OF   THK    TI'PKK    lATKI.MITV.  I2t 

over  the  scapular  notch  and  converts  it  into  a  foramen.  It  is  occasionally  nphKcd  by  hone 
(sec  page  84).  The  su])rascai)ular  nerve  jjasses  lieneath  this  li,t,'anient.  while  ihe  transverse 
artery  of  the  scapula  (suprascapular  artery)  passes  over  it. 

The  inji-rior  transverse  lii^amcnl  (Fiif.  n)-,)  is  much  weaker  than  tlu'  superior  one.     It  (on 
sists  of  delicate  connective-tissue  fasciculi  which  form  a  l)ridge  iieneath  the  base  of  llii'  acromion 
where  the  sujjraspinous  and  infrasjjinous  fossa'  communicate  wilh  each  other,  and  (oNcrs  (crlain 
small  branches  of  the  blowi-vesscls.     The  lif,'aments  of  the  scapula  belong  lo  that  class  of  liga 
ments  which  take  the  place  of  bony  strui'ures. 

THE  SHOULDER- JOINT. 

The  shoulder-joint  (Figs.  19,^  to  197)  is  the  articulation  between  the  glenoid  cavity  of  the 
scai)ula  and  the  head  of  the  humerus.  The  f^lfiioii!  cavity  is  relatively  small  and  very  slightly 
concave,  but  it  is  considerably  enlarged  and  (leejjened  by  a  markedly  fibrous  articular  lip,  the 
glenoidal  lip  {glenoid  lif,ament)  (Fig.  nK)),  which  surrounds  the  margin  of  the  lH)ny  socket. 
In  spite  of  this,  however,  the  socket  of  the  shoulder-joint  is  still  considerably  smaller  than  ihe 
head  of  the  humerus,  and  conseciuently  doi     'lot  interfere  wilh  the  free  movemeni  of  the  latter 

bone. 

The  articular  capsule  (Figs.  194  and  11)5)  is  roomy  and  relaxed,  as  must  necessarily  be 
the  case  in  a  freely  movable  enarthr)sis.  It  arises  from  the  margin  of  the  glenoidal  li|)  and 
is  inserted  into  the  anatomical  neck  of  the  hunums,  and  aUhougli  il  is  in  itself  thin,  it  ac<|uires 
considerable  strength  from  its  adherence  to  the  tendons  of  the  surrounding  m  iscles  (supra- 
spinatus,  infraspinatus,  teres  minor,  subscapularis)  and  to  a  reinforcing  ligament,  the  loraio- 
humeral  ligament  (Figs.  195  and  k);).  This  ligatiunt  arises  from  the  outer  Inmler  of  the  ba:.> 
of  the  coracoid  process  and  passes,  independently  at  ("irst  and  then  inseparably  connecti'd  with 
the  UP1K.T  and  iK)sterior  i)ortion  of  the  capsular  ligammt,  to  the  insertion  of  the  latter  structure 
in  the  neightx)rhoo<l  of  the  two  tuberosities.  \  somewhat  weaker  lasiiculus  strengthens  the 
inner  jMJrtion  of  the  capsule. 

.\  i»eculiarilv  of  the  shoulder-joint  is  that  it  lontaitis,  throughout  its  entire  length,  the  tendon 
of  the  long  head  of  the  biceps  (see  page  188).  This  tendon,  which  arises  from  the  supraglenoid 
tuUrcle  and  is  adherent  to  the  ujjper  portion  of  the  glenoidal  lip,  passes  through  the  articular 
cavitv  iK-neath  the  coracohumeral  ligamen'  and  leaw^  it  at  the  intertuberc  ular  gnniM-,  Ining 
accompanied  for  a  certain  distance  outside  of  the  joint  1)\  a  tubular  prolongation  of  the  synoxi.d 
membrane,  the  inlertulurrular  miKoiis  sheath  (I'igs.  n),?  and  1071-  ri'i>  portion  of  the  inter 
tulxrcular  groove  is  lined  with  cartilage.  .\l  the  termination  of  the  mucous  sheath  the  svnovial 
membrane  is  closely  adherent  to  the  tendon,  .and  il  also  extends  Ix'neath  the  tendon  of  the  uli 
sca]ndaris  muscle  in  the  shape  of  a  bursa  which  communicates  with  the-  articular  ca\ii\  (Fig. 
icj<).  This  suhseaputar  bursa  has  a  very  thin  wall  and  is  siluali'd  iHtuath  the  concave  anterior 
surface  of  the  coracoid  i)rocess,  Ixlween  the  coracohumeral  ligament  and  the  reinforcing  libers 
of  the  internal  portion  of  the  capsule. 

Till'  sti.mlilrr  jiiint  is  ihr  ninvt  (rnly  mm.ililr  .irlii  ul.tliuii  in  tin  nuin  luini.m  UhIv,  .md  |Hrmils  ut  mi'viniinl^ 
in  .ill  iliriiti"n>      'I'lir  i  hiif  imnfrntiil^  iiriv    |Hniluluni  munniinl-  in  I  hi   -.ikiImI  pl.im  .  wliii  h  an-  nmri  r.xli-nsui    mii 


4  ; 


Hi 


■^ 


l' 


122 


ATLAS   AND   TKXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  198.— The  left  elbow-joint  seen  from  in  front  (§). 

Fir..  199.— Ttie  left  elbow -joint  seen  from  l)chin(l  and  from  the  radial  side  (?). 

Fio.  200. —The  bones  v)f  the  left  forearm  with  the  interosseous  membrane;  the  annular  ligament  has 
l)een  divided  (J). 


I  Iff 


I  ' 


'!l 


rinrly  ih.m  postcriorlv;  r.iisinK  .ind  lowering  iif  llu'  arm  in  a  1  oronal  |iiani'  (alMlurtion  anil  aildui  ti<m,  ihi-  former  motion 
not  ix.'inR  possitilc  U'vond  a  horizontal  |ilanil;  anil  rmation  of  the  arm  alx.ut  its  longituilinal  axis.  During  the  move- 
ments of  the  arm  the  eapsular  ligament  is  thrown  into  folds  \i\Mn  unu  side  and  made  tense  uixm  the  other  and  in  certain 
extreme  positions  it  may  ai  t  as  a  ■ '  -ck  ligament. 


THE  ELBOW- JOINT. 

Thi.'  tllx)\v  joint  is  a  typical  comijound  joint,  bcini;  formed  by  the  association  of  the  lower 
end  of  the  humerus  with  the  u^jjer  ends  of  the  radius  and  ulna,  and  so  consisting  of 
three  articulations.  The  trochlea  of  the  humerus  articulates  with  the  .semilunar  (f,'reater  sigmoid) 
notch  of  the  ulna  (the  hiimiro  ulnar  artktilation),  the  cai)itulum  of  the  humerus  with  the 
depresserl  .surface  on  the  head  of  the  radius  (the  humeroradial  articulation),  and  the  radial  (lesser 
sijjmoid)  notch  of  the  ulna  with  the  articular  circumference  of  the  radius  (the  proximal  radio- 
ulnar articulation). 

The  three  articulations  are  surrounded  by  a  common  articular  capsule  iFigs.  i()S  -.   ■ 
which  i>  HHimv  and  relaxed,  particularly  in  front  and  behind.     It  encloses  the  threi 
th.  lower  end  of  the  humerus  (the  olecranal,  coronoid,  anil  radial  foss;ei.  is  attached  to    'i  a 

just  below  the  tip  of  the  olecranon,  al  the  mar.nin  of  the  semilunar  (urealer  si>,'nioidi  not.  .i,  and 
at  the  tip  of  the  mronoid  process,  and  the  entire  head  and  the  fjreater  portion  of  the  neck  of 
ihe  radius  are  situated  wir'iin  it.  The  only  portions  of  it  which  are  firm  and  tensi'  are  the  lateral 
ligaments  and  the  annular  lii'amrnt  which  surrounds  the  upjur  end  of  ilte  radius. 

There   mav  be   re»()i;ni/e:l  a  radial  or  external  lateral  lii^ament   and  an  ulnar  or  internal 
lateral  lii;am(nt.      The  radial  lateral  lii^anienl  {  Im^'s.  1()8  and  i.)())  ari-es  from     le  estevnal  ei>icon 
dyle  and  jia^ses  a>  two  fasciculi  to  the  annular  liKamenl,  whh  whiih  a  jiorlioii  of  ils  tilnrs  are 
nmtinuous.     The  ulnar  lateral  ligament  (Fi>;.   luXl  ari>e^  from  lln    internal  ejiicondyle  of  the 
humerus  and  passes  in  a  radiatini:  manner  to  ihe  idnar  iiiar^iii  i>f  the  semilunar  notch. 

The  annular  lii^amenl  (Fii;.  ii)i)>  i>  a  lirm  teu'^e  liuament  wiiit  h  surrounds  the  liead  of  ilie 
radiu--  like  a  slini;  and  fornix  three  fourths  of  ihe  i  ircumference  of  the  so(  ket  for  the  pivot  joint 
of  ihr  j)ro\imal  radioulnar  arlii  ulalion.  ihe  riMiaininj'  fourth  beinn;  formed  by  the  radial  (!e>ser 
-i^'inoid)  tiiiiih  of  tiu-  ulna.  Tlie  liijament  .irises  from  ihe  anterior  margin  of  the  semilunar 
ijireatir  simnoid)  tioldi  and  is  iiisirted  inlo  llie  i><)siirinr  margin  of  tin'  nidial  noUli.  Hclow 
it  the  lapsule  is  tliin,  and  at  ilie  ne(  k  of  the  radius  forms  a  small  proirusion  wliidi  is  known 
as  the  saeeuliir  reiew. 

The  braihialis  aniiiiis  musLle  passes  ,.ver  ihe  anterior  surface  of  the  capsular  li^jament  of 
the  ellwnv  jojnl  1  !■  iti.  .!0i  1  and  Mime  of  lis  liUrs  are  inserted  direttlv  into  this  siructure.  The 
tritcps  musde,  jiartii  iilarly  lis  middle  head,  holds  a  similar  relalion  lo  the  |K)sterior  surface  of 
the  cai>sule.  from  which  liie  lendon  of  ihe  musde  is  separated  by  fattv  ti.s.sue. 


Intrniiil  i/iin'/iilv/i 


I  'I liar  IdtiTiil  iijitniuiit 


/xtiniii/ 
i/iKvndvIr 


Rii<1i<il 
lulirni    ■ 
lif;amiiit 

Anmiliir 
/i/jiimciil 


fy'illhll'i 


Xrliiiiliir 

.'iipsiili' 


r  \teriiii! 
Iiiltiiil 
liiiiiinciil 

iiriiiliir 
lifidiiunt 


iii(ti>n  of 
hi  I  I'll  •< 


Sriiii/iiiKir  iidtch 


MW 


ik4 


Aiiiniliir  riii'^iili'  of  ili^tut 
iiiilii'-iilmir  iirtiinliitioii 


fh'.  200. 


Aiiiiiiliir 
liiiamiiil 


Arliiiilar 

dtriirtitetrntr 

('/  riutiw. 

Iiiidoii  of 
liici/i-i 


<)/i/i,/iii' 
/ii-iiiiii  III 


llll'lll/inilli' 


• 


i    ■■ 


Hi 


<l 


m 


II    i 


-■>.—■    . — 


THE  JOINTS   AM)   I.IGAMF.NTS   OF   TlIK   IPPKR    KXTRFMITY. 


1^,5 


From  a  nhvsioloRical  standiK.int  the  cl'oow  is  a  combination  of  two  jomts  only,  smcc  the 
humcro-ra.lial  articulation  does  not  ftmction  as  an  independent  joint.  These  two  jomts  are 
the  hinge  j<,int  of  the  humero-ulnar  articulation  and  the  pivot  joint  of  the  proxmial  radu.  ulnar 
articulation. 

Th,-  n>..i..n  „f  the  f.marm  upon  the  arm  i.  not  a  pure  hin^e  motion,  but  rather  that  of  a  spiral  joint,  .ime    the 
f  f    h    ,  .KhU  ,  .  n.l  tlu.  median  ri.lge  of  the  semilunar  not.  h    reseml.le  that  of  the  worm  of  a  >,  rew.      bron,   a 

r,.i.,.rfiv.- hones  ire  scareelv  in  eonlait  ilurinR  flexion.  ■      ,r       \ 

'''^^^■S:;::;.:!-:';:!::! -'u;;:.l"i"-.v  passlveU.  invoU..  in  ,he  p.... ment  of  .he  pro.,,..  ra.,io.>nar  ,oint 

sinee  t^'r!;:;;:  :;;:.':  in  .he  ...We.  a,«,u,'ts  ion.  a.is,  an,l  the  a-tua,  pivot  n,oven,ent  takes  p  tee  .n  the  prov 

ana  distal  ra.lio-ulnar  articulations.     Both  movements  of  the  elhow-ioin.  are  ,  o.npie.elv  „„l,.pen,lent, 

THE  DISTAL  RADiaULNAR  JOINT   AND  THE  INTEROSSEOUS  MEMBRANE. 

The  radius  and  ulna  are  connecte.l  l.y  a  thin  inlrrossrous  mvmlmmc  i  Fig.  :oo)  which  alny.sl 
comple.elv  nils  Ihe  spate  intervening  between  the  two  b..nes  of  the  forearn,.  .  .-  at'aehe.l  to 
,he  interosseous  ridges  of  the  two  bon.  s  ami  consists  for  tite  greater  part  ot  hbers  wh.cit  pass 
obliquelv  .lownwanl  from  the  radiu.  to  the  tdna.  It  does  no,,  however.  eMen.l  -o  ,l,e  t„.per- 
moM  part  of  the  interosseous  space  and  ,.osse>ses  an  opening  in  i,s  lower  ,.ort,on  tor  lite  ,.assage 
„f  bl.KHl  vessels.  11  represents  a  memi.ranous  supplement  m  il,e  bo.us  ol  the  lotvarm.  and. 
lii<etheseslru(lu,es,  it  gives  origin  to  various  muscles. 

,„  „i,li,ion  lu  the  connection  bv  the  interosseous  membrane,  tl,e  radius  and  ulna  are  hel. 
,ugt.tlH.ralM.l,v  the  .W/7".■/^^'^m■»/.l••ig>.r..,and.oo^  winch  passe>nl,l,MUelvfn,,nllu;..,nMt,,,. 

pro.es>  of  the  ulna  L-lhe  lower  margin  of  th.  tulxTosity  of  ,he  radius,  .nd  „  dtreclly  ,n  .onl.ul 

Willi  die  tipper  iiorlion  of  liie  interosseous  meml)rane. 

The  .li^hil  r.dwiilmr  hint  (Figs.    -o.  to  .0,1  i-  'lie  joint  betw.-en  ih.^  ..rit.  uiar  ,  iirum 
R.n.nce  of  the  ca|,itt,lun,  of' the  uhta  and   th,.  uin.,    isigtroi.l.  n„.,h  of  ,h.-  ra.lm.  an.,   a K,, 
,,.,ween  ihe  ,  apilulum  of  ihe  ulna  ami  llic  ar.i.uiar  .Um    whi,  h  st.pMr.tlc  .h,    h.:.,!  ol   liu-  uin,, 
f,„m  Ihe  iriqueiral  -cuneiform,  bon,  .     .Xnalmni.ali.  il  i>  an  indepen.Un,  ,o„.,.  bat  1,  tun.l.on^ 
in  assotialion  with  the,    ovi,iial,-,i,iio  ulnar  arliculali.m. 

Tl,e  s.Hkel  f,.r  du  .apiluhim  .-f  ih.-  uh.a  ■  Kig.  -'O.-.  i^  fonv.e,!  b;  ,„■  .Inar  no,.!,  ,.  ,h. 
rulius  as  well  as  bv  the  ,„-ncuiar  dis.  ;  ihe  portion  of  ,l,e  s„.  ket  formd  Us  iW  r,„bus  ,-  ah,,,,-, 
verlital  and  that  ft-rme.l  bv  the  .lis.-  is  praCi.allv  itori/or:  .1,  and  .  p..rlion  ol  ihe  lai,  ,;d  s„rla., 
„  uvll  i>  the  inferior  surfatr  of  th.'  .ap.udtim  of  ti,e  ulna  c,,„s..<|uenlly  res,,  ,n  ih.^  s.„  ,..,  1  ol 
;,,,  i,.i,„,  Tite  a,licular  cai-suie  is  so.mwlial  r,H,mv  and  relave.l,  and  ..  prol,,nga,,„n  ol  .1 
k,iown  as  ihe  s,.,.ul.,r  nass,  exten.is  upwanl  betwe.  t,  the  Ihmu,  ot  ,h.-  forearm  ,.lH,ve  iht  K.,1 

'"    ''\\l'Zi,uLr  ,li^r  is  allach.^l  upon  <.ne  si.je  to  line  tilnar  margin  of  Hie  .nnl.li,-  r'"-">  >''' 
the  radius,  where  it  ins-'psibiv  merges  in.o  the  <artilaginou>  covering  of  this  porl.onof  tin  bon.  ; 


i ; 


i  i 


ill 


m% 


I.        ! 


I  r 


ATLAS    AND    TEXT-BOOK    OF    HUMAN    ANATOMY. 

lumd  (i). 


„,„„  ,h.  ,«1»  ,i.l..  it  i.  ..uclK,,  ,«  ...c  ..yloid  ,.-«»  ot  ,ho  „,na,     I™  rare  in.anc,  i.  i. 

jicrforalL'tl. 

r        il   mt  till'  ulni  which  i~  simuUaniously 

The  movenK-n.  in  .h-  .li..al  ra.li.vulnar  join,  is  a  -••^''■;"  ''    ''"^^^nown  as  pronaiio,,.  ,he  radius  is  apphcd 

earn.,  ou,  in  ,ho  „n.xin,a,  .aa.,-uh,a.  ani.u,..,.n  ^^ ^^^^^^^  )Lr.  ,„  L  ,.a.aUc.  p„si,i„n  of  U.  ,.o 

„,,|i,,..lv  to  Ih.  ulna,  so  ,ha.  Uu-  .wo  bom-s  .  ros.s.  f^^  l'^"^' ,    '^,.^,„^^  arlicula.ions  ..asses  .hrouRh  .he  hea-ls  of  Ixnh 

aljout  .he  ulna  amounts  to  about  i8o  degreeb. 

THE  JOINTS  AND  LIGAMENTS  OF  THE  HAND. 

Those  of  the  carpus  are:  (.)  The  radn.arpal  -;-'^  "  "^  /     .^^      -      h     nu/...  m<7„i.r/>./ 

"""rle  j:t:of  .he  angers  indu.le  the  ...... ^.^/<./.'«.-/  -^/-''-'"-  -^-'  "^^'""  ^  '""^ 

blitilaitiiciil  arliiiihilioiis. 

THE  JOINTS  OF  THE  CARPUS. 

ra.Uus  an.l  the  triangular  ar.ieular  d.e  ..nerpose.    bet.     n     ^      "     ^^  ,  ,^„„,,.. 

,.,.,  ,x,ne  upon  one  side,  and  -he  pn.Mmal  -' -;  !'  ^^^Z    J^  j      .^ ,     ,„„,  ,;;.  ..her.  the 
navicular  (seaphoi  1,.  lunatum   ,semdunar  .  and  ''''I '.\^™;;\  •;.''.  ^.J^^^  .cuneiform)  lx,ne 

navicular  and  lunate  l.nes  -!'->-';;j  ^^^  ^^^i    :         r^^         "'-  -^^''^^  ^"^"^ 
,vi,h  the  triangular  ar.Kular  d.se  m  su  h  a  "^' "';,.^.  ,^,^^,  ,,„,„  f.,m  a  condyle. 

;;;;=rrrrt::;-::::r--^^^^^^^ -'^ 

.*«-—«"■": -•■v'';''';x";;:::'';:":'"r';:!;"::"n.ai  ani,- ,«.„ «,».!», 

i-n.ni  liK    Mi.ip.    cii   I.     .•.M.y...     ••„  in  d  livin  in  the  coronal  iliameler. 

,,i,„.     The  curvature  of  the  surfaces  ,s  ^'reat.r  ,n  the  .ag.t.al  ">■"    "  j„^,.,„„, 


Iriir/is 


fliiinaiis 


Ohrranon  fossa 


Tendon  of  triceps 


Snbaihineons  olecranat  bursa 


Synovial  cavity 


Coronoiil  fossa 


/  '  */       I roctiica  of  hiiincrus 


•aian  vein 


lirachiul  ai  icrv 


(  Ina 
his.  201. 


I  Ina 


Railiw. 


Di^ta/  radioulnar  articulation 


Articular  disc 


I  rii/iiclnitn      ^    , 
Intercarpal  articulation     I':'- 
I  la  lua I II  III      /.fi 

(arponietaccrpiil  articulation     f.  . , ' 


.Metai  arpal  hones 


(Uipilaliiin 


I  iiiiatc  hone 

Radiocarpal  articulation 

\iivi(nl,ir  hone 
Radial  lull  ml  ligament 

\        (ireatcr  niiiltan^iilar  hone 

>\  \         i.iini"ii,ttu<in*ta  lit 'tt:iliiri."t 
,'f  rliiimh 
\    \       Metacarpal  hone 

/(>-'/■  iiiiiltiin^ii'ar  hone 


\\\ 

w 


m 


fin.  202. 


i 


.1* 
f 


I  \  ' 


i 


im^ 


^, 


THE  JOINTS   AND   LIGAMENTS   OF   THE  HAND. 


125 


the  one  side,  and  by  the  proximal  facets  of  the  greater  and  lesser  multangular  (trapezium  anc 
trapezoi.l).  capitate  (os  magnum),  ami  hamate  (unciform)  bones  upon  the  other.  I  he  hrs 
row  of  the  carpal  bones  practicallv  forms  a  socket  for  the  head  of  the  cap.tatum  |os  magnum) 
and  the  proximal  portion  of  the  hamatum  (unciform),  and  toward  the  radial,  and  to  a  certam 
extent  also  the  ulnar,  side  of  the  j<.int,  the  proximal  row  exhibits  a  convex  and  the  .l.sta  row 
a  concave  surface,  since  the  navicular  bone  presents  a  convexity  toward  the  greater  and  lesser 
multangular  (trapezium  and  trapezoid)  Ixmes.  As  a  result,  the  line  of  the  jomt  .s  not  a  simple 
curve,  but  has  an  irregular  CO  shape  (Fig.  202).  ,    ,  ,  ,     ,•  ,,1,,. 

The  articular  cavitv  of  the  joint  is  ver>  complicated,  since  it  extends  from  the  actual  articular 
line  both  proximallv  and  distallv  between  the  in.lividual  carpal  Ix.nes  of  Unh  rows.  It  is  sep- 
arated from  the  rad'iocarpal  joint  by  the  previously  mentioned  ligaments,  and  sinular  ligaments 
connect  the  tones  of  the  second  row  and  separate  the  in.ercaq.al  from  the  caq.o-melacarpal 
articulation.  The  latter  separation  is  incomplete,  however,  and  these  two  articulations  usually 
communicate  totween  the  capitatum  (os  magnum)  an<l  the  lesser  multangular  (trapezoul)  Ix.ne, 
since  interosseous  ligaments  are  usually  wanting  in  this  situati.m.  The  thin  articular  capsule 
exhibits  no  special  peculiarities  ami  resembles  that  of  the  railiocarpal  articulation 

The  articulatio»  oj  the  pisijorm  bom  is  a  small  unimportant  joint  between  the  contiguous 
surfaces  of  the  pisiform  and  tri<,uetral  (cuneiform)  bones,  and  is  usually  an  independent  art.cu 
lation.  As  the  ].isiform  bone  is  simply  the  sesamoid  bone  of  the  llexor  caq-i  uhians,  this  joint 
i.  analogous  to  those  situated  between  the  sesamoid  bones  of  the  great  toe  and  the  hea.l  of  the 
l-.rst  metatarsal  Ix.ne.  The  ligaments  arising  from  the  pisiform  Ix.ne  are  similarly  to  be  regar.led 
as  continuations  <.f  the  tendon  of  the  llexor  carpi  ulnaris;  they  are  tlR.  p,so  hamate  Ir^amnil 
(Fi.r  ^04),  passing  to  the  hamulus  of  the  hamate  (uncif<.rm)  Ix.ne.  and  the  piso^metacarpal 
ligament  (Fig.  204>,  which  pa.sses  to  the  base  of  the  fifth  metacaq.al  Ix.ne  and  sends  prolonga- 
tions to  the  neighlH)iing  metacan)al  Ix.nes. 

Th.  carpometacarpal  hint  iFig.  202)  is  the  joint  between  the-  bases  of  the  secon.l  to  the 
Ufth  metacarpal  In.nes  and' the  distal  articular  facets  of  the  lesser  muhangular  (trapezoid),  of 
a  small  portion  of  the  greater  multangular  (trapezium)  (see  page  01),  capitate  (os  magnum  i, 
und  hamate,  unciform  .'bones.  The  articular  cavity,  which  is  usually  single,  communicates, 
as  a  rule,  with  tiie  intercarpal  juinl  in  the  manner  previously  .lescribed.  It  is  sometimes  com 
,„.sfd  <.f  tw(.  separate  articulations,  eacli  of  whicii  connects  two  metacarpal  Ix.nes. 

Th.  b<.nes  forming  tlie  carpometacarpal  articulation  are  capable  of  <.nly  sliglit  m,.vemei,ts 
and  the  articular  ca].su1e  is  c..nvsp,.n.!ingly  tense  and  llrm.     In  a<l<liti<.n  to  the  previous  y  m.n 
tioned  surfaces,  it  also  unbraces  the  lateral  articular  facets  Ix^tweeii  the  bases  ..f  the  ind.vi.iual 
metacarpal  Ix.nes  (sir  page  (,.),  and  the  articulation  cnscpiently  includes  the  concealed  mter 
metacari.al  articulati(.ns.     The  articulation  i>  an  arlhnKlium. 

Tin.  carpo  metacarpal  inint  oj  the  thumb  is  the  joint  between  the  sad.lle  shaped  articular 
facet  at  the  distal  ex.remitv  ..f  the  greater  muhangular  Ix.ne  (trapezium)  an<l  the  base  of  the 
metacarpal  of  the  thumb,  'it  is  alwavs  an  independent  articulation,  communicating  with  none 
uf  the  other  carpo  metacarpal  jcnnt^  nor  with  .ny  of  the  carpal  ioin.s.  From  the  shape  of  the 
articulating  surfaces  the  articulation  is  a  siddle  j..int,  and  although  the  surfaces  are  not  com 
jiletely  congruent,  it  is  the  most  j.ronounced  saddle  joint  in  the  human  body. 


Mi 


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„6  ATLAS    AND   TEXT-BOOK    OF   HLMAN    ANATOMY. 

s:;--S:;!;::::;£=-rf^F 

ligament  havinjj   Ik-imi  removed   (i). 
Fir..  .o5.-ArlicuUuion..  of  the  middle  finger  >ecn  from  the  sule  (i).  ^  ^ 


.hicf  movomcnts  of  ,l,o  hand  .u-  ncx.on,  ..f    --;^^'^^:^:J"    'jLi,,;,.  ,,  .,1.-,  .n  almost  complete  cinumduc- 
Ix-ttcr.  ulnar  alxiuCion).     Ify  a  cmb.naU.m        .nc.c  mo^cmcnt.  ! 

tion  of  the  haml.  .,„,i  ovtrn^ion      The  aN.-s  of  rotation  of  the  tw..  liinp- joints  are  not 

The  ,  hicf  nxnements  of  the  jomts  are  "">""  •"'  "^^^  ^  interseCinR  ea.l,  other.*  During  fe- .  ,n  of  the-  ra.lio 
placed  at  ri^ht  angles  to  the  axis  of  the  forearm,  '-  "^^^'^-^  ^^^ilar  movement  in  th.  int.,  ..n.u  articulation 
larpal  articulation,  the  han.i  .leviates  to  the  rad.al  ^'^'J^^^X^^^n.^  f.e  other  exten.ied,  the  movements  in  the 
the  han.l  .leviate.,  to  the  ulnar  side  an<    f..r  -.rr^.'-  '.„,.„,  (ra.lia'       ulnar  abduction,  as  the  ,ase  may  be) 

a..is  of  the  extremity  neutralise  each  o.her,  whtle  the  '^  '-■ '  ^     '^ "^     ;  ,^,  ,„„,,„,ms  neutralise  each  other  and 

are  more  pronounced.     If  toth  joints  are  iL^Ned  or  extend,  d  top  th.   ,  tl 

,hc  movements  in  the  axis  ,.f  the  extremity  (nexiot,  or  ""■'-"";";  J'  "^,       ,„„,,,,,,,    ,„,  i,  particularly  true  of  the 

The  carpo-metacarpal  articulauons  are  artlu.Kha  ^J^^^^^  ^^,,.„  .,„  ,.,„„,;,,  .,f  Ute  hand  is  increased 

carpo-metacarpal  joims  of  the  secoml  and  thtr.l  hnRcrs.     T1k>  mm      U  „„i,i„„  „f  ,he  little  finger. 

„r  diminished,  that  is  to  say,  during  hollow.ng  or  natten.ng  ■■'    '  ^^^is    ih  m.'e  extensive.     Like  all  saddle  joints 

The  range  of  motion  of  the  carpo-nte.acarpal  ynu    of  '^      hun.      s  mu  ^^^  ^^^  ^^^^^^^^^  ^^  ,^^  ^^^^^^^^ 

it  is  biaxial,  but  owing  to  the  incongruitv  of  the  -"-'-"«  ^^'^    '™  mav  be  so  combined  that  actual  circum- 
more  pronounced  than  those  of  the  other.  ''';■  -"rl;  ^l      m    awav  from  the  index-fmger,.  addu.  tion  (toward 
TZ:.^^:^J::^'^'^^^  r^;:r  o;;1.  to  ..  ...^...     ...n.  the  .tter  motion  the  con. 

cavitv  of  the  palm  is  markedly  mcreaseil. 

THE  CARPAL  LIGAMENTS. 

:!;:v;r;:.  «;u»  a,:;; ,.;  ,1.  .„,,„  n.,™™.  .-„„-„  ,.„,-„„,. .., »»,  „.,.,.  .„. 

1  iiL  ui/».M..  r  i,„„„,.  .,,,,1  i<  itt-ichi't  Dartii'iilarlv  in  llic  trit  uetrai 
U,  the  dorsal  surface  of  the  Urs.  -^ -^;>;;;;;^  J  ^  ^  ^  2  r.uUocar,a,  U,a„u:,>  ,Fi«. 
(cuneiforr^t)  ..>ne.  I  he  ---^'"  ■^. '  '  ^^  ^^^^^  .,  ,He  articular  surface  of  the  caq-us 
3041.  is  lonuer  than  the  dorsal  one,  it  ariM..  tiom  inc  ma  _  ,„;„,,_,  ,nc  .na-mtim^. 
and  is  inscrtetl  not  only  intt,  the  tones  of  the  lu>l  nv.,  but  a...-  :utu  th.  ■  .p.... - 

,.    ,f  ,1„.  hmd  his  bein  materiallv  m.Klitied  by  the  more  n^cent  studies  .,f  these 
,This  description  of  the  -'"■"";:';       ;'„:':,,  ,,,,,.1  l..nes  cannot  move  upon  each  other;   during  ra.lial 
•iniculalion-.      It  must  not  be  suppose.l  that  th.   two  r  »^      .        i 
Z^Z  the  navicular  Ixine  is  markedly  moved  toward  the  adjacent  l.nes. 


CM 


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UlMh 


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Tin     JOINTS    AND   I.IOAMKNTS   ('V    li.i     HANK. 


127 


The  trait  verse  car     '  (andrinr  niiiuhi     li^iur  )il 
which  servo        rcf.  r.ter       .  of  th,   k.n-  1 

unaa-sson-l.-amcni       ;hc  ca         .     It  conm■ct^  wo  car,.;.! 

to  th(.     idius,  and  convciis  the  .  1  groove  into  a     anal. 

V\.  n  the       'or  of  the  caq)a,      mal  are  found  .  ic  l.-ini,    ' 
ran-al  I" -lies  (!-,'.  204):   thcy  rad  ,ae  toward  thr  h«    d  ni  the 
tlu  W(//a/c  carpal  lif^amfiil. 

The  remainin<;  carpal  hgamch!>  which  urn,     ihe  .         d 
h,„,..  of  the  meta.aqial  bones  are  d(si<Tnaled  accordin-  lo 
intercarpal  li.^amnils,  the  iv;/,;r  and      'rsal  carp"  nui^i     rpal  , 
number     and  dorsal  (four  in  number,    has.  '  mr«/.s  (I-igs. 

basal  liganenls  a      situated  in  t'       nter^^   la  n  ihe  bases 


ig.  2S2)  is  u  ])ani.      aly  stronij  liijamc  nt 
tendons  in  i>la(e  i>er  i)a<^e  205)   !ha 


but  is  ab'     ilta(hed 


hich 


. onnecl  th( 
OS  mai'nu' 


iixidua.i 
forniinu 


-  or  I  onnect   ihem 
''ion  as  the  u.l'ir  ,' 
*  and  the  vol 
'    20)   .      Tlu      '.'/' 
melan'-pal  h>    vr 


rvv 


'lis 


'iictacarp 


T) 
■/(j/flH,!,  "/  arliciilai 
.nes  am'  ihc  ba-r- 
,_  ir     ,    ..rly  sph(      al,  th- 
irfaces  of  the  hea         f  ti 
..  t  of  the  bones,  so    Hat 


IS. 


T 

..f  tb^ 
>urfaces 
articular 
almar  a> 

uurin'/       Mon  they  are 
and      ..    rtxlial  ty])es  (.C'C/v 
an  e-cei.  :;ion;  ii  rescml 
The  articular  car 
-einf'  '■'•'I  in   several 
headh  ^ "  th'   metacarj  - 
>rr..ill  deurt 


a.  (...nuicl  durhifz  extension  are 
IS  ,,rc  ionse(|uently  a  mixture  of 
rile  nutacarpo-])halan,ueal  joint 


vi-'f;^ 


;nt. 
)Ut  ihev  are 


th 


F1.NGEP 

-05)  ar.   the  joints  1^  n  the  heads 

iialansies.     AUhou.^i  arliculatin.i; 

nts  are  restricted  b>        linenl.-.     The 

■come  M.mewhal  cvlinurical  ui)on  the 

herical,  while 

;j';i^lvmoid 

'11       umib  i> 

■  ian-eal  articulations  and  is  a  true  giniilym. 

■md  205)  are  thin  and  somewhat  relaxe. 

lalrral  //,!,'() hic»/.^   are   excenirically    in,->erted    into    the 
V.  become  ten>e  during  llexion  of  the  phalan.nes;   thev 
es  of  the  heads  of  the  metacarpal  bones  c^ee  page  i)2 
reinforced  by  the  accessory  volar  lii^aiiiniLs  (Fig.  J04 
he  llexor  tendons  (see  page  205),  and  hv  the  Iraiisvcrs. 
M  ilat  strong  ligaments  connecting  the  hea.ls  of  the  sen.nd 
dorsal  surfaces  of  the  capsules  are  proteded  by  the  d..r 
.euro,es  01  m.      .^e..  >...  .^s^  205),  which  are  intimately  connecte,!  with  them. 
The  nu-lacarpo  phala,r>ical  ioint  oj  the  thumb  always  contam.  two  sesamoid  l..nes  (a  radia 

and  an  ulnar)  (Fi..  204),  which  are  embedded  in  the  articular  capsule;  th      ^ 's  .hivcc. 

toward  the  articula     .n  are  covered  by  cartilage.     Sesamoul  bones  occa>...ia.,,     ■  <  ur  n,  tlu 
melacarpo-phalang.      ioint^  of  the  other  lingers  (see  also  page  <)2  :. 

which  pLs  from  .he  hamulus  of  ,hc  han,.,.  : ..  iforn,.  l,.,.-,-  ,„  ,hc  has.  of  ih.-  „Uh  nu-c,  arpal  ,k„„..    „  >.-  ,h, 
meUic.irptil  ligamcnl. 


arise  tP 
The  a 
which 
capilulii 
to  tl'.c  ti 
a|X)neuro 


ir  surfaces  of  ' 
connec  led  wid 
■(F(7)»CH/\  I  Fig. 

n  ni<  ;..        ^al  lx)n 
i  of  in.     ngers  (see 


;     ,.•     il' 


i 


M 


128 


ATLAS    AND   TEXT-BOOK   OF   HUMAN    ANATOMY. 

Fig  206 -The  female  pelvis  with  its  ligaments,  seen  from  behin.i  (§). 

Fig  207  -The  female  jK-lvis  with  its  ligaments,  seen  from  l)elovv  (s). 

Fig  208  -The  male  pelvis  vith  its  ligaments,  seen  from  m  front  (j). 

Fig  209  -The  female  pelvis  with  its  ligaments,  seen  from  in  front  (s). 

Fig  210 -The  male  pelvis  with  its  ligaments,  seen  from  above  (j). 

Fig  211  -The  female  pelvis  with  its  ligaments,  seen  from  above  (s). 


.,ne  extensive  n-.auon  is  in,..,ssih.c.  the  phalanges  an..  e.,nse„uentK-  the  fingers  can  be  atx.ucte..  and  a.Muc.ed.     The 
mc'taearpo-i.halangeal  articulation  of  the  thu,nl>  is  a  pure  hinge  joint. 

The  dMal  or  inter phalangca!  articulations  (Fig.  205)  arc  the  joints  between  the  individual 
Phalanges  of  the  Imgers,  the  bases  forming  the  articular  sockets  and  the  trochlear  -rfa.^s  co.- 
stJturng  the  articular  heads.  The  articulations  are  pure  hinge  joints.  Lateral  hgamcnts  (I-.g. 
20  T^the  sial-s  of  the  capsules  prevent  any  lateral  motion,  an.l  tlu^  articular  capsules  are  roomy. 
Volar  flexion  is  the  only  movement  of  which  these  joints  are  capable. 


It    I 
l>    i 


THE  JOINTS  AND  LIGAMENTS  OF  THE  PELVIC  GIRDLE. 
THE  PELVIC  LIGAMENTS.  SYNARTHROSES  AND  DIARTHROSES. 

The  pelvic  gir.Ue  and  its  ligaments  form  the  prMs  (Figs.  2o(.  to  2. .  ami  2,5).  which,  unlike 
,he  II  girdle,  is  complete  l.ith  anteriorlv  an.l  posteriorly,  the  pu I.k  bone,  being  conneaed 
antedorh  1^^.  svmphvsiJ  antl  the  p.hic  ginllc  complete,!  posteriorly  by  the  sacrum,  whuh 
•iriiculates  with  the  two  iHuclx.nes  either  by  joints  or  half  joints. 

It  s^  pin  is  p„l>is  (Figs.  208  an.l  20.,.  is  a  mixed  synarthrosis  connecting  the  symphysial 
surfa  '  o  the -two  pubic  boius.  These  surfaces  are  coveretl  with  cartilage  ""->  <'^^-l-; 
^  them  is  niletllv  a  mass,  consisting  largely  of  dense  connective  . issue  and  par,  v  cif  .  bn^^ 

.  t  C.  -hich  i>  ,erme.l  the  int.pulu,  „l,roa,r,i,a„:  This  interpubi.  tissue  is  ^-f^^^ 
;,;: ;  lihind  .,,.1  its  ,H,s,erior  portion  frequently  contains  a  space  resembling  an  articular  cav.t> , 
s„  thit  the  svmi.hvsis  is  ..mverte.l  into  a  half  joint  (amph.:ulhn.sisi. 

n    Uuivsis  is  reinforce.1  by  libers  which  pass  across  its  upper  margin  fr.,m  te  pub.c 
spine  .^  one    ide  to  that  of  the  other;   dus.  (ibers  an  intimately  connected  w„h  dte  i,,U.,^b. 
r    ncirlilP'e   ind  form  the  superior  pulu.  li,,nu,,U  ,  !■  ig.  2.0).     'I  he  lower  margin  of  the  s>m 
r- 'rXf;::lf  bv  a  more Llep^'den,  structure.  ,he  arn.a.  iinl.ior  p.^in  l,..^cnt  (F.gs. 
20^,'and  20«1,  Which  is  approximately  triangular  and  rounds  oft  the  ,H.bic  angle. 

T  cT-s Uricr  con,Jc;ion  of  the  peluc   girdle  is  a  paire.1  arbcula.ion  which  ;---;; 
.„,roil.a,  artnulation.     It  .Kctirs  l.tween  the  auricular  Hirfa.  e  of  the  sacrum  --       --1;-^ 
n  med  surface  of  the  ilitmt.  and  is  an  almost  intntovable  j-in,,  a  trtie  am,,hiarthros.s         h 
:::;;;  irregular  surfaces  of  the  two  Ix.nes  are  scarcely  adapted  for  reciprocal  movements,  and 

,       .  i;.,__,.„. rr,..,o,i:n.r  ihr  articulation  further  insure  ,ts  immobihty. 

'"  TZ^^  ;;rbeing"comH;.«l  bv  .he  auncular  surfaces.  ,h.    innominate.  In.n,.  and    tite 
sac  nl:  f  als^  h-id  toother  bv  a  strong  ligament  passing  iK.ween  the  tul.ros.t.es  of  the  two 


■r^fSPHF 


W 


m 


Short  ,,ost.  sacro-iliac.  lig.     f;^™;, 

li^timi'fit 


Iliolumbar  ligament 

Short  posterior  sacro-iliar  lig. 


(jreat  tro- 
chanter 


I  is-.er  M/cw-V""''"'' 
ligaiiiiiit 


I  esser  sciatir  fornmen 


iiij^iiimi!  iifi'i 'liilli 

Artii  iilar  viijiyiile  Xmiati 

Itgamenl 


I 

■  i 


ii 


,1/  hii>  ioint 


i  i 


\ 


1 1 


:il 


!t 


l.iimhar  vertebra  l\ 


Anterior 


\iiterior  loiiiritiidimil  lifiiimeiit 
llioliimhiir  //y 


Anterior  sujurinr 
spine  of  ilium 


Greiil  Iroihantrr 


inal  li^. 


itlar  cii/isiile 
hi/i  joint 
lliofimoral 


it 

■  i 


i! 


i  > 

ill 


!  1 


r 


t      ^.r  "-•>   ■.'  '•*>\i  t*:.' 


f  r 

i 

■ 

» 

! 

i     • 

1 

i 
I 

't 

1 

1 

lil 


ih 


Anterior  longitudinal  tig. 


Lninhar  vertebra  IV 

Iliolumbar  lig- 


Anterior  saero- 
iliac  lig. 


r 

1          Great 

\        ■  seiiitir 

loiiiiuen 

JH  im 

1  esser 

.*.  ^-^^ 

^K'^ 

••lititic 

M---i^^m 

foramen 

Suiwrior  piibie  //■,'. 
f-liT.  210. 


:  lllj 


II 


JM 


It,:.  211. 


fh 

[  ■ 

!l^ 


i 


ih 


^ 


THE   JOINTS   AND   LIGAMENTS   OF   THE   PELVIC   OIKPI.E. 


129 


space  between  the  tuberosities  of  the  .burn  ami  ^^^^^^^^^  ^  svndesmosis.  but  from 
les  are  connecte.!  anteriorly  by  an  ^l'^'-^*-';--  ,  '  :^Li\:,,,  .,  ,h.  ar.i.ui.tion, 
the  physiological  stamlpoint,  the  syndesmos.s  -J*^^;  ^^ ,,  '  '  ,  '"^.i^,,,  ..^he  entnv  trunk, 
since  it  firmly  unites  the  pelvic  bone  to  the  ^^  -;  J  '  ^j  ^  ,,,,t,,,:  Ute  ani.rior  sarrn- 
The  sacrum  and  ilium  are  als.,  ---"^  ^  ^  ^^t  Cands,  con,,osed  ..f  transverse, 
mac  li.amnus  (Figs.  20S,  ^^°' .^"^  .,^'--^\;'"''^.  ff,,  Hor  surfac  of  the  sacrum  in  front  of 
oblique,  and  fre<,uenlly  interlacmg  hbers,  from  !!^  '^^    ™'  .'       j^.  ^„  ^,,^,  ,;„,,  ....ninalis; 

.he  liosacral  joint  to  the  anterior  surface  oi  the  .hum,  -<  -^^  ^  J^.  ,.,  „^,  ,,,„^,,,,.,  , 
the  ^.s/.T/<>r  sacroiliac  lif^amcUs  (Pigs.  206  and  2,,^  "/.;;'";  \  j^^^  „f  ^^  „,,„,,„,  .,f 

long  and  a  short  Ugament.  The  ./,<>.  7'-;,:;;';;;^:,^:  hi  "res,  in  the  region 
fibers  which  pass  obliquely  ^-"^^^  ;-;^;  ^  ^,;:Z^,.,„  i.  composed  of  superficial 
of  the  posterior  mferior  spme.      The  loni,  posUrwr  s  j,^^^^,^, 

'TX^t^  :r  T,;:ii,':r  ii™!:;:-:';- .;.: ->.-- ,-."  -; 

iK)rtion  of  the  dorsal  suriatc  rorresuond  ng  short   ligament 

the  sacrotulnrons  ii^rcat  sacroscialic)  Usamenl.     It  cosers  in  the  corrcspon      g 

:::;;;r=e.;^:=-  ■  r;::.;:";^  ^: >■  -..  -  --. 

but  also  w  ith  the  sacrum. 

THE  INDEPENDENT  LIGAMENTS  OF  THE  PELVIS. 

m  n >«».«-  -^'-»'' ;';-•'>■  :;7;',;';::;';^:r;;r:;:l'u.;t';  E"":i 

of  the  obturator  gn...ve,  the  opening,  tlie  obturator  an,a.    .1  ig.   -H". 

.1        .^    ■    .v.rnm.r    is    it    passes    downward,    but    again    broaden-    out   n.ar    1 
ll   becomes   narnmir    as    11    pa..i  ....-nwuinoiis  li-ament  I'OsUrimK ,  and    the 

inu,  the  tuberosity  of  the  ischium.     I.  covers  "-..r"' ?'  ~;- '^„J..  ,^.  ,„,  ,07.  is  .. 
:....  lijraments  are  a.lherent  at  their  m.crsection.      1  he  /.,/<//,.  m  ^'""  ''^^  ,  ,;,^,.;„ 

narrow-  oblique  c.mtinuation  of  the  sacrotubenms  ligament,  which  ,.assc.,  alon^        • 
of  the  ischium  ami  pubis  and  gradually  disapi-ears  anteriorly. 
0 


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1     : 


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hi, 

I'! 


;  ! 


f  : 


ii 


130 


ATLAS    AND   TEXT-HOOK    OF   HUMAN    ANATOMY. 


The  sacrospinous  {lesser  sacrosciatk)  ligament  (Figs.  206,  207,  210,  and  211)  is  more  deeply 
situated  than  the  sacrotuberous  ligament,  and  arises  from  the  lateral  margins  of  the  lower  {wrtion 
of  the  sacrum  and  of  the  upjjcr  [wrtion  uf  the  coccy.x.  It  rayjidly  becomes  narrower  and  jiasses 
almost  horizontally  forward  and  out\\ard,  crossing  the  sacrotuberous  ligament  shortly  before 
reaching  its  insertion  at  the  tip  of  the  spine  of  the  i.schium.  Its  pelvic  surface  covers  and  is 
adherent  to  the  coccygeus  muscle  (see  Splanchnology). 

The  sacros])inous  ligament  converts  the  greater  sciatic  notch  into  an  elli|)tical  foramen  which 
is  termed  the  ^reat  sciatic  (sacrosciatic)  joramen,  and  the  two  ligaments,  the  sacrospinous  and 
the  siicrotulxTous,  convert  the  lesser  sciatic  notch  into  a  foramen,  the  lesser  sciatic  (sacrosciatic) 
joramen.  This  latter  foramen  is  triangular  with  rounded  angles  and  is  separated  from  the  great 
sciatic  foramen  by  the  sacros])inous  ligament.  The  sacrotuberous  ligament  forms  a  ])ortion  of  the 
outlet  of  the  pelvis. 

THE  PELVIS  AS  A  WHOLE. 

The  following  l)ones  enter  into  the  formation  of  the  pelvis:  the  two  innominate  Ijones,  the 
sacrum,  the  coccyx,  and  the  fifth  lumbar  vertebra;  and  its  boundnrics  are  also  partly  formeHi  by 
the  intcrpubic  fihrocartilage,  the  obturator  membrane,  and  the  sacrotuberous  and  sacrosulnous 
ligaments.     The  iliolum.bar  ligament  forms  a  jwrtion  of  the  ])elvic  wall. 

In  the  pelvis  may  be  recognized  the  jalsr  or  greater  pelvis,  and  the  true  or  lesser  pelvis.  The 
former  forms  the  llewr  of  the  alxiominal  cavity,  am'  is  wide  open  above  and  in  front  and  is  btnmded 
only  ])artly  by  lx>ne.  Its  cavity  is  considerably  larger  than  that  of  the  true  pelvis,  from  'vhich 
it  is  separated  by  the  terminal  (ilio])ectineal)  line  (Fig.  210).  It  is  boumled  by  the  al;e  of  the 
ilium,  by  the  fifth  lumbar  vertebra  together  with  the  jiromontory,  and  by  '  two  iliolumbar  liga- 
ments. 

The  true  or  lesser  t>'''vis  is  a  short  canal,  the  greater  ])ortion  ot  whose  i.  undarit'S  are  bony. 
TIk'  anterior  wall  is  short  while  the  ])osterior  one  is  considerably  longer,  and  it  is  open  aljove  and 
Ixlow.  The  up))er  opening  is  termed  the  superior  aperture  oj  the  pelvis  or  'he  pelvic  inlet  (Figs. 
210  and  211),  whose  lx)undani-  is  formed  by  the  terminal  line,  by  the  jjromontory,  and  by  the  upper 
margin  of  tile  inter|)ubic  fibrocartilage.  The  terminal  line  is  composed  of  a  sacral,  an  iliac  (the 
arcuate  line),  and  a  ])ubic  (crest  of  the  ])ubis)  jjortion. 

The  actual  cavity  oj  the  pelvis  is  lM)unded  posteriori}-  bv  the  concave  ])elvic  surface  of  the 
.sacnmi  and  by  the  anterior  surface  of  tln'  coccyx;  laterally  by  the  jielvic  surfaces  of  the  IxKJies  of 
tile  iMum,  jiubis,  and  ischium  (the  lloor  of  the  acetabulum),  by  the  sacrotulxTous  and  sacro- 
spinous ligami'uts,  by  the  rami  of  the  pubis  and  ischium,  and  by  the  obturator  membranes;  and 
anteriorly  by  the  symplivsis  ])ubis  with  its  lit;aments  an<l  by  the  anterior  extremities  of  the  I.  ' 
|)ubic  lx)nes. 

Tile  anterior  wall  of  the  ])elvic  cavity  is  by  far  the  shortest,  while  the  |)osterior  wali  is  the 
longest.  The  |)osterior  portions  of  the  lateral  walls  exitibit  two  o|)enings,  the  un])er  elliptical 
greater  sciatic  foramen  and  the  lower  triangular  lesser  sciatic  foramen;  the  anterior  portions 
contain  the  openings  in  liie  obturator  membranes  whicii  torm  the  obturator  canals  (seejjage  I2()). 
The  upper  more  capacious  jiortion  of  the  pelvic  cavity  is  designati-.l  as  the  plane  oj  pelvic 
expansion,  while  the  inferior  contracted  |)ortion  is  known  as  the  plane  oj  pelvic  contraction 


^tm 


THE   JOINTS   AXT>   LIGAMENTS   OF   THE   PELVIC   fURni.E. 


13' 


The  inierior  aperture  oj  the  pelvis  or  pelvic  outlet  (Fig.  207)  is  bounded  by  the  louxr  margin 
of  tlu-  symphysis  (arcuate  ligamenU,  by  the  tuben.sitiesof  the  ischium,  by  the  inferior  ram.  of  the 
ischium  an.i  i)ubis,  by  the  sacrotuberous  ligaments,  and  by  the  tip  an<l  the  lateral  margms  of  the 
sacrum.  These  boundaries,  unlike  those  of  the  peine  inlet,  do  not  lie  m  the  same  plane.  he 
coccyx  forms  the  lo^vermost  point  of  the  pehic  outlet,  and  next  come  the  tuberosities  ol  the  iseh.a. 
whit-h  project  do\yn\yard,  Nyhile  the  boundary  curyes  markedly  uj-ward  in  the  region  ot  the  sacro- 
tuberous ligaments  and  particularly  at  the  lower  margin  of  the  symphysis. 

The  angle  ^vhich  the  t\yo  inferior  rami  of  the  pubis  form  \vith  the  symphysis  is  kno\yn  as  the 
pubic  angle  (Fig.  209).     It  is  rounded  olT  by  the  arcuate  ligament  to  form  the  puh,c  arch. 

The  pehis  is  not  horizontal  but  inclined,  the  degree  of  its  inclination  yarymg  in  dillerent 
indiyiduals,  but  usually  ayeraging  alx>ut  60  degrees.  The  plane  of  the  peKic  inlet  conse.|uently 
passes  obliquely  from  aboyc  downward  and  from  liehind. 

The  pehis  exhibits,  as  does  no  other  portion  of  the  skeleton,  tyjiical  sexual  characteristics. 
T his  i.  particularly  noticeable  in  the  true  pehis.  In  the  female  the  false  peh  i>  i>  lower,  broader, 
and  flatter,  and  the  ale  of  the  ilium  usually  show  a  less  marked  curyature.  Tiie  true  pehis 
exhibits  similar  characteristics,  an.l  its  cavity  in  particular  is  more  caj  ac.ous.  In  the  ma  e  the 
pehic  inlet  is  heart-shaped  (from  the  marke.l  projection  of  the  promont.m),  while  in  the  female 
it  is  elliptical,  and  the  pehic  outlet  ■  the  male  is  also  much  narrower  than  in  the  female  on  account 
of  the  conyergence  of  the  tuberosities  of  the  ischia.  The  pubii  angle  in  the  male  peh  is  forms  an 
acute  angle  of  alx>ut  75  degrees,  while  in  the  female  it  forms  a  right  or  obtuse  angle  «,o  to  100 

'^''^'^I^r'a  more  detailed  account  of  the  pehic  diameters  and  of  the  pehis  in   its  relations  to 
obstetrics  tlu-  reader  is  referred  to  the  text-lx.oks  ami  atlases  of  topographic  anatomy. 

The  inguinal  or  PouparCs  ligament  (Figs.  207  and  200)  is  not  one  of  the  actual  ligaments  of 
the  pehis  but  is  a  portion  of  the  a,.oneurosis  of  the  external  oblique  muscle  ol  the  aUlomen.  It 
arises  from  the  anterior  superior  spine  of  the  ilium  and  is  inserte.l  into  the  spine  of  the  ,.ubis. 
An  almost  horizontal  continuation  of  the  ligament  passes  from  its  insertion  to  the  upper  margin 
of  the'  h.)ri/.ontal  ramus  of  the  pubis,  forming  the  lacunar  ((Hmbernat's)  ligament  ( !•  ig.      • ). 

THE  HIP-JOINT. 

The  hip-joint  or  coxal  hint  is  the  articulation  between  the  acetabulum  of  the  innominate 
bone  and  the'head  of  the  lemur.  The  acetabular  cavity  is  considerably  deepened  by  a  strong 
circular  iibroeartilaginous  ligament,  the  glenoidal  Up  (cotyloi.l  ligament)  (l-ig.  2i(,),  so 
that  the  socket  embraces  more  than  half  of  the  spherical  head  of  the  femur,  and  the 
joint    conscpiently    iK-longs   to   that   group  of  the   spheroi.lal  articulations   which   is   known 

as  an  enarthrosis.  _ 

The  glenoidal  lip  <Fig.  214)  "f  the  hip-joint  is  triangular  in  cross-section  antl  stretch<-s  acn.ss 

the  notch  of  the  acetabulum,  converting  it  into  a  cleft  like  loramen.     This  i-orlion  ot  the  gle 

noidal  lip  is  known  a'^  the  transverse  ligament  (Fig.  214). 

The  acetabular  fossa  (Fig.  2.4)  does  not  come  into  dlre.l  contact  wtih  the  cartdagmous 

surface  of  the  head  of  the  femur  and  is  not  covered  with  cartilage,  but  by  a  cushion  of  fat  and  In- 

synovial  villi.     From  this  fattv  cushion,  and  particularly  from  the  acetabular  notch,  there  arises 


1!    I   I 


■|^ 


132 


ATLAS    AND   TEXT-BOOK   OF   HITMAN    ANATOMY. 


Fig.  212. — The  ripht  hip-joint  seen  from  in  front  (§). 
Fig.  213. — The  right  hii)-joint  seen  from  behind  (§). 
Fig.  214.— Socket  of  the  right  hip-joint  after  ( utting  through  the  articular  capsule  and  the  round  h'gamcnt. 

The  head  of  the  femur  has  been  remove<i  (j[). 
Fic.  215. — Section  through  the  pelvis  and  the  two  hip-joints  taken  in  a  i)laiic  almost  at  right  angles  to 

the  axis  of  the  pelvis  (ij). 
Fig.  216.— The  right  hiji-joint  opened  through  the  anterior  wall  of  the  articular  cajjsule.soas  to  show  the 

round  ligament.     The  head  of  the  femur  ha.^  been  drawn  out  of  the  socket  and  rotated 

outward  and  backward  (J). 


'  t 


V' 


-A 


a  broad  characteristic  lipimcnt  of  the  hip-joint,  the  round  ligament  {ligamcnlum  teres)  (Figs.  214 
and  216),  which  becomes  slightly  narrower  and  is  inserted  into  the  depression  on  the  head  of  the 
femur.  This  ligament  is  flat,  and  only  its  external  i)ortion  is  formed  of  lirm  connective-tissue 
fasciculi;  in  its  interior  nutrient  vessels  pass  to  the  head  of  the  femur.  It  lies  in  folds  u])on  the 
cushion  of  fat  in  the  acetabular  fossa,  and  on  account  of  its  length  and  soft  structure  plays  little 
part  in  checking  the  movements  of  the  joint. 

The  strong  articular  capsule  of  the  hip-joint  (Figs.  212,  21.^,  and  215)  is  markedly  reinforced 
In  accc.sson-  ligaments.  It  arises  from  the  outer  circumference  of  the  glenoidal  lip  and  embraces 
not  only  the  head  of  the  femur  but  also  the  greater  jK)rtion  of  its  neck-  .\nteriorIy  it  is  inserted 
into  the  intertrochanteric  line;  jiosteriorly  it  does  not  extend  so  tar,  and  surrounds  only  somewhat 
more  than  the  half  of  this  portion  of  the  neck  of  the  femur. 

The  reinforcing  ligaments  are  firmly  adherent  to  the  cai)sule  of  the  hip-joint  and  are  com- 
posed of  longitudinal  and  of  circular  fibers.  The  latter  are  known  as  the  orbicular  ligament  (zona 
orhicularis)  (Fig.  215)  and  embrace  the  narrowest  j)ortion  of  the  femoral  neck;  they  pursue  a 
cir(\ilar  course  within  the  innermost  fibrous  layers  of  the  capsular  ligament  and  are  rather  inti- 
ma'  ly  ci  nnected  with  ihc  longitudinal  ligaments.  The  longitudinal  fasciculi  receive  dilTerenl 
nannsacco:  ling  to  their  i)la(cs  of  origin,  and  since  each  of  the  three  ])arts  of  the  innominate 
bom  gives  origin  to  one  of  the  fast  i(  uli,  they  are  (onseriuently  known  ;is  the  iliojenwral,  pubo- 
capn  ''tr,  and    ischiocapsuh:    'igamrnis, 

i  110  iliojcmoral  ligamei::  (Figs.  m2  and  2i()i  is  the  strongest  of  the  three  ligaments  and 
is  one  (.f  the  lhicke,-t  ligament-  in  the  body.  It  arises  in  the  region  of  the  anterior  inferior  spine  of 
the  ilium,  iia-ses  obli(|uely  acro>-  the  .interior  suri  ;-  c  of  the  articular  cajisule,  broadening  as  it 
goes,  and  is  inserted  into  the  entire  length  of  the  intertrochanteric  line.  The  puhocapsular  liga- 
iiiitil  (Figs.  2i2and  21O)  arises  from  the  horizontal  ranuis  of  liie  pubis  and  passes  ac  ross  the  inner 
and  posterior  portion  of  thearticular  capsule  towanl  the  lesser  trochanter.  The  iseliioca  psular  liga- 
mcnl  (Figs.  215  and  2181  ari>es  from  the  Ixxly  of  the  i-,i  hiiini  and  runs  in  the  jiosterior  jiortion  of 
the  capsular  ligament;  the  majority  of  its  libers  pas.-  into  the  /.ona  orbicularis,  but  some  of  them 
converge  upward  to  the  great  trochanter. 

The  thinnest  places  in  the  caii:.;:;e  of  the  hip  joint  are  r-ilUalcd  in  it-^  lower  j-ortiiin  b.-'^veen 
till  jiubocapsular  and  the  ischio.  apsular  ligaments,  and  above  the  zona  orbicularis  between  the 
istliiocajisular  and  iliofemoral  ligaments.  There  is  also  a  thin  place  in  the  aniero-internal  wall 
of  the  capsule  between  the  iliofemoral  and  puljocapsular  ligaments,  and  a  communication  occasion- 


\'^ 

Tendon  o/'^^^^y     :j! 
'  rtiis  fcmoris     >^^    ,  '^-1 

'i     1 

lliofcmonil     jU/  i 
ligament       Wi-^r—- 

tiniir  troclmnli-r    J^'JiIm  j^^ 

/9«-^  ' -111 

/'li/'oeapsnliir  ligament 


lendi'n  of 

net  11^ 
Jeinoris 


liinald 


Artiiit/iir 


(ilii/e'il  liihiiv^ilv 


/i\'.  21  i. 


Iriiii'iyrrse  lii^nnuut  of  lutlahiiliiin 


III 

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i 


Aiilirinr  smro-ilinc  li^. 


Hciiit  of  Janiir 


liitrivs-^ivus  sdt  o-i!iiii   lii;. 
Siinv-i/i(ii-  <iitiai/(ilh>n 


Sarivs/iiiii'ii^  lioiiiiii/il 
Sdcivtiil'iivii'^  lit;'. 


Ohiiinilor  imwhniiir  Arai.iU  li,i;.  of  /uilih 

l„t,r/,„/m-  libwauHlufic  '^'"""'  ''■'-'■ 

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THT;  joints   AXD   MGAMKNTS   of   TIIK    PKI.VIC  CIRDI.I,.  133 

ally  exists  at  this  -oint  hctnc-cn  the  synovial  cavity  of  the  hip  and  the  ilwpcctincal  bursa  which  is 
situated  beneath  the  ilio{)soas  muscle  (see  page  211). 

The  hip-joinl  i,  a  l)all-an.l-s<Kk.-t  joint,  a>„l  allhouRh  thr  smkrt  cml.ra.rs  murv  than  „nc-half  „f  ihr  .nh.rical 
head  of  th..  U-mur  an,l  limits  th-  rang.,  of  motion  to  a  sliRht  extent,  movements  in  all  dire,  lions  ar.-  possil.le      Si„, ,.  ,he 

hea,  of  the  femur  fomts  a  mark.-,!  angle  with  the  avis  of  the  hone,  the  as^s  of  mov.ment  of  the  j,.int  .Lh^s  n tss  through 

but  forms  an  a.  ute  angle  with,  that  of  the  femur.  The  ,  hief  n.ove.nents  of  the  hi|.-joint  are  aNIu.tion  ami  a.Mu,  tio,', 
(siM-aration  an.l  approximation  of  the  lower  extremii  .  ,  llexi.m  (anteriorlv)  an.l  .xtension  (,iors.,l  |l..,i„n  is  inn,o.,il,l,. 
on  acTount  of  the  tension  .,f  ,h..  iliof.-,,.  ,r.,l  ligament),  rotation,  an.l  ,  in  um.lu.tion.  Wh..,  the  joint  is  half  M.-x.-.l  (the 
middle  posi.L.n)  all  ..f  the  ligamenN  .ire  relaxed.  In  the  upright  position  the  iliof.-moMl  ligaments  are  fnse  a,,,! 
steady  the  |h1vis  upon  the  femora. 

The  roun.l  ligament  has  n,>  m.-.hani.al  fun.tion  whalev.r,  hut  a,  ts  .imply  a.  .,  ligam.nt  of  ron.lu.li,.,,  ,s....  page 
.08).  It  IS  ,H.asi,.nally  wanting  in  man  an.l  regularly  al.s..nl  in  many  aninuls,  „n,l  is  to  U-  reganl.-,|  as  an  oriKinallv 
extra-anieular  stru.ture  pn.bahlv  ..  po.tion  of  the  ju'etineus  mu^.  1.-,  « hi,  h  has  lH.en  .lispla...,!  into  th..  joint  The 
head  ,.1  the  femur  is  hel.l  in  its  so.ket  m>t  only  l,v  the  strong  .  apsular  ligaments  hut  also  by  atmosph.ri.  pressure. 

THE  KNEE-JOINT. 

The  kncciohit  (Figs.  2,7  to  222)  is  the  articulation  hetween  the  condvles  (and  the  arlicul.r 
surface  for  tlie  patella)  of  the  f.  ,.„r  an.l  the  .ondyles  of  the  tibia,  and  the  posterior  surfa.e  of  ihc 
patella  is  al.so  passively  involved  in  the  formation  of  the  articulation.  DisregardinK'  the  p-,i.  I|-,  ji 
will  be  noticed  that,  in  contrast  to  the  elbow,  ody  two  lM,nes  are  inchulcd  in  the  articulation  as  ,he 
fibula  IS  completely  excluded  from  ii. 

From  the  form  of  its  articular  surfaces  as  well  as  on  at  couni  of  the  manifold  t  hara.  icr  of  its 
.structures,  the  knee  joint  is  one  of  the  most  complicate.'  ,irti.  ulaii.ms  of  the  human  l>.«ly  Tiu. 
arliculatinK  surfaces  arc  incnuruenl,  sin.e  the  n.n.avities  of  the  cm.Mes  of  th..  til.ia'ari  less 
than  the  ...nvcMties  of  the  con.lyles  .,f  the  femur.  Th..  j.mornl  unul.lrs  ai..  M.parat...!  bv  the 
deep  mter.-.n.iylar  f.issa,  an.l  their  posteri.ir  p..rtions  are  spherit.d  «hile  their  ant.  riur  stirf.L.s 
ar.>  cylin.in.,.1  ^id  unif  in  fr.,nt  ..f  the  inter.-.,n.lyl.,i.|  fo»a  to  form  th..  arii.ular  surfa.e  f..r 
the  pate  la  ( Kig.  .201.  Or.iinarily  the  .-on-lyKs  .,f  ,he  femur  pr...,,,  tluir  ex  lin,|ri.,.l  s„rfa...s 
to  the  nbia  ami  th..  articulati.,M  is  .„nse.,uently  a  hinge  j<.int.  th.-  inl.  r.  ,.n,M„id  .mimn...  ,>f  the 
t.b.a  iH.ng  re..  ,ve.l  int..  the  inter..,n.lyl.,i,|  noi.h  of  the  lemur  an.l  preNcnling  lateral  .lisi.la., 
ment  of  the  art,,  t.lating  surfa.vs.  The  m..sl  posterior  portion.  „f  th,.  f..n,.„a|  ..m.Mcs,  houexcr 
ar..  .ph.rical,  ami  wh.n  they  rest  u,H,n  the  comix  les  ui  th.  tibia,  .luring  llexin,-,  ,.,  ,h,  kn..  j.-int' 
they  form  a  .l.nible  arlhr.Hlial  j„inl.  JMom  the  sh,.,,,,  ,„•  ,-,.  „.,i,„|ating  s„rfa...s  ,h..  kn.e  join,' 
IS  .-.insciuently  a  ginglym.i  .irthr.KJial  arti.  ulalion. 

I'lxm  th..  comiyle  .if  ihe  tibia  are  situal...l  lu,.  ,un,is,i,  „l,i,h  from  ti„  ir  „.,sitio„  .„,■  i.rm.-.l 
the  n.t.nu,   ami  the  ,x,,r,u,l  mnn.u.s  ,  |.,g.  ,,, ,.     Th.v  ar..  !„;,  |,..,s..K  .    „,„    „.,1  u  hi,  ih..  .on 
<lyles  of  th..  td.ia  ami  are  atta.he.l  onh    lo  .he  .apsular  ligam.nt   ,,n,|   to  du    in-,  r.  ..mM,.i.i 
emin.n.e,  ...  that  th.'v  max  b.   mov,.,l  ,,,,.,1,  ihe  surfa..,  .,f  ,|„  ,i|,i,,l  .„m!vl.s.     Th.  ir  .  ,„.,„  ,| 
margins  are  ihuk,  ih.ir  im,  rnal  margin,  thin,  ami  duir  .  r.iss  ,..  ,i„„.  ,„.  .|..i,|,,,|K    ,,„,„;, 
shape.  I.  ^ 

riu-  h,„n,.,l  n„„hn,s  ,ihe  h,l,r„<,l  snuilumr  n,tnh,,^,^  is  narr.iw.r  than  th,-  .m.  rnal  one 
an.l  .Iocs  not  form  a  ...mol.ie  s.-mi.  ir.  le,  but  is  ,.  s.  gm.nl  ni  a  .  in  K-  n  h-se  la.li.s  is  brg.r  liun 
that  ..f  .he  external  meni,.  u>.  TIk-  ,  v/,W  ,„n,i.  „.  .  ,l„  ,  v/,  n,„l  v  nnha.ar  ,„r,il.,„  ,  is  .dnioM 
compleulv  cutilar  an.l  is  ..p.n  .,nb  at  its  p.  inl  .,f  ,,tt,uhm.nt  h.  the  inlercomh  l.,i.l  emineme 


iiifl 


134 


ATLAS   AND    TEXT-BOOK    OF    HUMAN    ANATOMY. 


Fio.  217. — The  right  kiiec-joinl  in  vxlcn>ion  >een  from  in  front  (§). 

Fn;.   J18.   -The  right  knee-joint  in  exlensi.m  ^ecn  from  behind  (§). 

Fic-.   21Q.-  The  right  knee  joint  in  extension  opened  In  two  lateral  incisions.     The  quadriceps  nuis(  le, 

together  with  the  jiatella,  has  ]>een  reflected  downwani   (j). 
Fir,.   220      The    right    knee-joint    in    llcxion   after   removal   of   the   articular  lapsuie   and   the   lateral 

ligaments  (ij). 


i 


'-.h. 


h  is  broader  than  the  internal  meniscus,  and,  as  its  radius  is  smaller,  it  covers  the  condyle  of  the 
tibia  except  in  the  situation  of  its  relatively  small  median  hiatus.  It  arises  in  the  anterior  intcrcon 
dvloid  fossa  of  the  tibia  and  runs  to  the  ixternalinlercondyloid  tui)eiTle,  whili^  the  internal  meniscus 
])asses  from  the  anterior  margin  of  the  articular  surfaic  of  the  internal  i  inidyle  to  the  posterior 
intercondyloid  fossa.  The  anterior  lK)rtioll■^  of  both  menis(  i  are  connei  ted  by  fasciculi  which  vary 
greatly  in  their  development  and  are  known  as  the  lraiisirr.sc  iii^amfit,  and  lluir  thick  external 
margins  are  adheient  to  the  articular  capsule,  the  external  meidscus  being  le^^  inlimatel\- adherent, 
and  hence  more  mn\able  than  the  internal  one. 

In  addition  lo  liu'  niii>isci,  the  articular  ca\it\  also  contain-  two  iinportatit  aciessor\  liga 
ments.  the  <  rm  iiil lii^iimcnls  1  Figs.  220 and  2211,  of  w  hich  there  ari'  two,  an  aiilirior  and  a  poslcrior. 
Their  anterior  surfaces  arc  provide<l  with  a  s\  no\  ial  co\ering  which  passis  as  a  septum  through 
the  ]Kisterior  portion  of  the  arlii  idalion,  in  I  lhe\  are  strong  ligaments  firmly  connecting  the  tibia 
will)  tile  fcnr  '  Thex  Inith  arise  frut  he  iiisi  rcondyloid  fossa  of  the  femur  and  pass  to  the 
lulxr(le>^  and  iiiierc  ond\  loid  fossu'  oi  the  libia.  'I'he  anterior  ligannnt  has  a  broad  origin  on  the 
i  ,ner  surfac  e  of  the  external  condvle  of  thi  femur,  and,  iKcoming  narrowi  r,  it  passi^  lu  the  aiiti  tioi 
inlet,  ond)  loid  fo.sa  and  to  \\w  atUcrioi-  inicrcundyloid  tulxTcle  of  the  tibia.  The  posterior  liga- 
ment |iasM  >  from  the  outer  surf.ii  tof  the  internal  conilyleof  the  femur  to  the  ]«)stt  rior  intcrioti- 
d\loi  I  fossa  and  to  tin  (orrcsponding  tulxrcle  of  the  tibia;  it  i^  flat  ai  its  origin  but  rounded  at  it^ 
illM  rtion,  and  is  Usi'.dh  stronger  than  the  .iiitcrii.r  ligament.  l)i.ringri>l  iM'milh  \ion  ),  die  two 
ligament^  cross  i.i  such  a  wav  that  the  anterior  ('tie  is  in  front  ot  liu  posterior.  'lite  lan.i  r  1  usu 
alh  connei  te  1  v  ith  the  (sternnl  nieiiisi  us. 

\\  ith  the  c\i  ijilion  of  ( t  rtain  ili\crli(  ul.i  of  ihe  s\  no\  ial  membrane,  w  lii<  h  w  ill  -ubsci|uetitl\ 
be  doi  li'icd,  till'  artitulan  .(p'-ulc  is  .tllai  lied  to  ihe  m,irgin-of  the  (  arlilaginou^artii  iilar  surfaces. 
ii»  line  of  .iti.H  hment  upon  the  jio^tcrior  ■•uifaie  of  itii'  l\  mur  i-  indicated  !i\  the  inteicotulv  loid 
line,  -o  til, it  the  1  iitirr  ii;  ell  ond>  loii]  fos^a  is  sit 'la  ted  within  the  .utii  ular  iaMt\. 

Ihe  kiu  e  joint  ]Hisses-.»s  a  number  o!  |ieculiarilii^:  it-  -\no\ial  folds  are  mori'  pronouiued 
that!  tlio-e  of  an\  other  joint  in  tile  bmh  ;  it-  s^  no\  ial  menibrane  gives  ol'f  di\irti<  ula,  :.oi"i  of 
w  liii  h  .ire  of  l.irgc  si/(  and  pa--  beiii  .ith  tin  111  ighlrtuing  nni^i  li  s;  it  is  mui  ii  -tn  nglhi  ncd  If.  ihe 
majotiix  of  -.hi  overlving  luidons;  and  the  paii  ll.i  i>-  imbedded  in  the  aiilitior  portion  i.f  tlie 
arlii  ular  i  ap'-vile  .md  fornv.  the  ininndi.ite  anterior  boundary  of  the  artii  iilar  1  a\  it\ . 

rill  ma  jorit\  of  tlu  re m Ion  ing  lig.imi  nt- of  the  km  1    loinl  an  adhen  ril  to  the  1  ap-ulc  tlu'ough 
out  ;he  grciler  portion  of  their  e\'i  ■,      There  an-  luii  lateral  iiganienl--,  the  jihuhir  .\\m\  the  lil'ial 
I, 111  rill  lii;itit,,  III.     The  /;/)/'.//  tinhrihil ,  lii/i ml  /i:;<iiiif  iit  il'ig^.  j  1  7  and  .'iHi  ari-,i  s  from  th'   internal 
ipiionil\li  ,ind  i»  in'imalel)  adherent  to  the  lapsular  ligament;    it-  ^upert'n  ial  lilnrs  rvin  to  die 


Articular  miis 
of  kmr 


Siipriifxiti'lliit 
bursa 


Iriitlon  oj 
i/iiiiilrice/is 


I'dtfllii 


f  \t.  rrtiihi- 
III  III  III 

•>/ 
piiirllii 

I  ihtthn 
liilenil 
li>i- 
Dn'fi  III- 
friipn- 
Irlliir 
hiir-.li 


Hem)  0/ 
Jihiii'ii 


Intcniiil  iiitermnsailar  septum 
(Tendon  of  adductor  inaf^nus) 


Tendon  of  f^astrocncmius  ,■' 

(int.  Head)  X- 


(Juadrireps 


finilini  of  ^rmi 
iilfnihratnt-'ti'i 


liliial  lateral 
lil^ament 


Tihifi 


Int   leitntuiiliti'i 
•<l  imh,. II 


I  ihiiil  hileiiii  lit;iiiiiitil 


I'alellar   lit:iiiiinil 


hf,'.  21S. 


Temur 


Arii.  liar 
capsule 


trmltin  o/ 

^ii^frflinrrttm^ 

It -I.  hi'iidl 


l\tsterior 

capitular 

I'ii- 


I ihula 


i!  7 


It^.  217. 


fl 


iiji: 


ii'|. 


ii 


mi 


/  iliilhii 
liilira/  li 


(tuiilyle 


Aihmlitr 


Si!/iiii/ifilrlli 
till  I  ••11 


■^iiifiur  for  piilillii 


ilclltir  fi'/tl  of  yiioviiil  iihinbninf 


Inliriiiil  ivmlvli' 


r  /I'/ih 


ir  r.i/i>ii/f 


/'i'fii/iir  \inlii( 


lit:.  210 


AiiliTiiir  I  mil, 
li  I'll  "II  III 
Antiiior  iii/iili'/iir 


I  ill 


I iihiiii^ilv  t'l  lihiii 


]\  i 


I  r  !. 


i 
i     i- 

i 


I 


■' 


St 


s  1  11 


ihfi 


THE   JOINTS   AND   LIGAMENTS   OF   THE    PELVIC   r.tRDLE. 


'35 


inner  margin  of  the  condyle  of  the  tibia,  while  the  shorter  dee])  libers  pursue  a  somewhat  oblique 
course  and  i)ass  posteriorly  to  be  inserted  into  the  internal  meniscus  and  into  the  infraglenoidal 
margin  of  the  internal  condyle. 

The  main  portion  of  the  fibular  (external^  lateral  lif;aiiinil  (Figs.  217,  218,  and  2i())  is 
separated  from  the  capsular  ligament  by  fatly  tissue,  and  <  ()nse(|Uently  a])iiears  as  a  lirm,  inde])en- 
dcnt,  flattened  cord  which  passes  from  the  external  condyle  of  the  femur  to  the  head  of  the  fibula. 
A  deci)er  and  shorter  portion  of  the  ligament  ( the  short  external  lateral  ligament )  is  adherent  to  the 
ca])sule. 

The  ])osterior  wall  of  the  capsule  is  reinforced  b\  two  ligaments  wliich  arc  intimately  con- 
nected with  the  muscles  which  h.:ve  .heir  insertion  in  the  vicinity  of  the  kmc  jninl.  The  iHiqiic 
popliteal  Uf^ament  (Fig.  218)  is  a '-ontinuation  of  the  tendon  of  the  semimembraiidsu^  muscle  ami 
runs  obli(|uelv  from  below  upward  and  from  within  outward  upon  the  iiositriur  surfate  of  the 
capsular  ligament,  in  which  structure  it  finally  <iisapp(ars.  The  arcuate  popliteal  li\;ameut  iFig. 
218)  pa.sses  in  a  curved  manner  aljovv-  the  t"ndon  of  the  popliicus  muscle,  llu'  (nncasit}-  of  tlie 
curve  being  directed  ujiward.  It  runs  from  the  region  of  the  external  condyle  (if  \\\r  femur  to 
the  jH)sterior  wall  of  the  capsule  of  llie  knee  joint,  some  01  its  libers  pa^siI1g  also  to  the  iiead 
of  the  libula  and  to  the  deeper  fasriruli  of  tlie  litiular  lateral  ligament,  these  libers  being  termed 
the  retinaeulum  oj  the  arcuate  lii^at.ieiit. 

The  anterior  wall  of  the  knee-joint  is  formed  almost  entirely  by  llu'  linilon  of  the  f|uadri(  eps 
cruris  muscle  and  its  ccmiinualions.  The  tendon  of  this  mu-i  le  is  really  inserted  into  the  Kmm'  of 
the  i)atella,  but  it  is  continued  onward  as  the  llal  but  \ery  strong  patellar  lii^amei.t  i  l'ig>,  j  1  7  aii'l 
222)  which  ])asses  from  thi'  ti!)of  the  patella  to  the  tuberosity  oi'  the  liliia.  Tlu'  patellar  ligament, 
liowever,  is  indijiendi-nl  of  the  knee  joint  and  is  not  adiie.ciit  to  liie  ( .ip  ular  lig:iment ;  i;  is  one  of 
tht  thickest  ligaments  of  th.'  IkhIv,  an<l  it  is  separ-Ued  from  tlie  upper  mil  oi  ihi-  ti'i)i;i  and  from 
the  eaps'ilar  ligament  liy  fall\  ti--.-ue  and  b;  a  ((Mislanl  bursa,  the  n.ep  iiijrapiih liar  i>urs,t  \V\'Z. 
jj.'S  wiiieh  (joes  not  comni'inic  aii'  with  ti;e  syno\i.il  i.uil}.  Molli  ihe  p,  lelia  and  "'e  ariual 
tendon  of  tlie  ipiadriceps,  howiver,  directly  form  a  portion  of  ilii'  anterior  loiundarv  oi  ihe  \i'\\\\, 
aiMl  the  ,i!!T,  rior  |iortion  of  dt  ( ap^iil,;r  liganu  ni  i-  ai^o  r,inton  el  !>\  l.i'.er.d  iihrou^  1  onlmu.dion-. 
(if  the  i(u.ii!t.i  I  ]y-,  wliieh  are  known  as  the  inierne.t  and  <\liriial  palillar  ri  iitaiula  1 1- ig.  .'171. 
The\  ariM  trom  tiie  lali-ral  margin^  of  '.he  patella,  receive  libi  r-  I'roni  ilie  va^ii  upon  either  -ide 
i>i'e  |ia;;e  2  i  ^),  ;ind  pas>  .lownward  to  ihe  lateral  ni.itgin'-  ol  ilu  1  •  >n    •  li  -  oi  ihe  liliia 

Till  s\no\ial  l'old>  of  die  knee  joint  are  the  alar  jclih  !  I'igs.  jhj  an  i  -'_'.' 1  and  the  palillar 
synmial  jolil  V  \  -ji!.  'ihe  greaur  portion  of  die  al.ir  lolN  !  on-i^i  oi  liie  f.iiu  li-^sue  uliiih  i^ 
situa!e<l  beliiiiil  ■  ■'  1  lalellar  Hi;;!!!!!  nl,  .'iiid  i- 1  overe;!  b\  ihe  ^\  no'  1  1!  Mn  nihratie .  lh.\  pi"|iit  into 
lit'  iNllee  joint  doin  either  ^ide  o|'  iIk  pai  II. I.  The  palillor  sMWeial  juld  i--  .1  .ibroll^  hand  of 
•.a!i,l)le  ^i.'e  whiiii  uMially  (onlains  a  <  ()n-~ide;alile  i|uanli'\  of  fai ;  it  ari-i  ..  ireiii  ihe  anteiior 
v\all  of  die  1  .Lp-'iie  belAeetl  I  he  two  al.ir  fold'-,  w  illi  v\  hie  ll  il  i^.  1  omiei  led.  .01. 1  i-  i,i-i  rti'd  into  llu 
inleriondvloid  tos-.i  of  the  femur. 

The  largest  di\erlli  uhini  of  ihe  -\no\i.il  iiuinbr.iiie  of  llie  joint   1-  the   \iiprap>il< liar  hur^a 

Fig.  222\  "hiJi  eshnd^  U]  ward  beneath  tin    U-ndon  of  the  i|ua(iri(ep^  lVni"K-  l"or    iliiin-i  a 

hand'--   brradih       It   .dwavs  tommunii  ali  ■-   \mi1i   llu    •~\rio\ial   i.ivin.   u^Kalh    In    i|uile  ,1   Lu'lt 

aiterture.  and  rei  i  ue-  (he  in>ertion  of  thoM  libers  of  llu  i|u.idric  1  p-.  w  hie  h  .ire  tinned  llu  .irlii  ular 


r 

'« 

li 


136 


ATLAS    AND   TEXT-BOOK    OF    HVMAN    ANATOMY. 


t    i 


Fic;.  221. — The  c<in(l\lc.->  of  the  tihia  with  the  two  menisci  .ind  the  oiijrins  of  the  crucial  ligaments  (j). 
Fi(..  222. — Sagittal  section  of  the  right  knee-joint  in  extcrsiim.     The  section  passes  through  the  external 

cond\  Ic  of  the  til)ia  ( j). 
Flc.  22;,. — The  right  tiijia  and  fibula  with  thii)  ligaments  {{). 


muscle  of  the  knee  (subcrureus)  (sec  page  215).    The  suprapatellar  bursa  docs  r.ot  lie  directly 
u]K)n  the  anterior  surface  of  the  femur,  but  is  separated  from  it  Ijy  a  cushion  of  fat. 

There  are  two  or  three  other  considerably  smaller  diverticula  of  the  synovia)  membrane  at 
the  i)Osterior  portion  of  the  articulation.  These  are  the  popliteal  bursa,  Ix'neath  the  tendon  of 
the  i)oplileus,  the  semimembranous  bursa,  beneath  the  iendon  of  the  semimembranosus,  and  the 
internal  i^aslroenemial  bursa  (Fig.  ,■^04),  beneath  the  tendon  of  the  inner  head  of  the  gastrocnemius. 
The  last  two  bursa'  may  communicate. 

Thin'  :iri'  other  bursa'  in  the  ncightxirhtioil  of  ihc  knee-joint  whiih  have  no  ilirert  relation  to  the  articulation.  In 
adilition  to  the  previously  mentioned  deep  infrapatellar  bursa,  the>e  are:  the  siihculnneous  pre putelliir  bursa  (I'ig.  222), 
a  suIm  utaneous  bursa  which  is  constantly  found  in  front  of  the  patella;  the  suhjuuial  prepalcllar  bursa,  U'tween  the  fasi  ia 
and  the  tendon  of  tlu'  i|Uadriit  ps;  the  sublciuiinous  prepatellar  bursa,  iKtween  the  ijuadriteps  tendon  and  the  i>eriosteum 
of  the  patella;   .ind  the  subcutaneous  iiijra patellar  bursa,  which  is  situated  in  front  of  the  pntellar  ligament  (se'_'  also 

IKiKi'234)- 

As  mi^ht  Ik'  supposed  from  the  shape  of  the  artii  ulatinR  surfaies,  there  are  two  kind..  >l  nioti"i'  possible  in  the  knee- 
joint,  a  hin(;e  motion  1  Itexion  of  the  lei^  and  the  return  to  the  extended  posit'on)  and  a  Tiio\emf  ai  of  rotation  which  is 
[Kissible  only  when  the  kriee  is  flexeil.  Rotation  is  imiMissible  when  the  knee  is  extendeii,  not  only  from  the  shape  of 
the  articulating  surfaces  (sec  page  i v;l,  but  es|>eually  on  aciount  of  the  tension  of  the  lateral  liKamenls,  which  are 
relaxed  only  during  llixion  of  die  joint.  The  latenil  ligaments  e.lso  prevent  a  lateral  displacement  of  the  iHines  during 
flexion  of  the  artii  ulation.  The  i  .-ucial  liRaments  serve  mainly  to  hold  the  fei  ,ur  and  tibia  together;  they  an'  so  situated 
that  ime  of  them  is  always  tense  in  any  position  of  the  joint,  the  posterior  lig.imi  ill  liiing  tense  durim;  part  of  the  move- 
ment of  llexion  and  part  of  the  mo\ement  of  extension,  and  the  anterior  one  during  ilu  wl.iile  of  'lexi'in.  The  cruiial 
ligaments  also  <  ho  k  the  movement  of  nitation. 

The  palell.i  glides  ui«in  the  surfan'  of  the  femur,  anil  has  no  influence  upim  ihe  nu-i  liani.s-i  of  the  ar.iculation. 
During  exten..ion  of  the  joint  it  Is  pulled  upward  by  musiular  action  anil  daring  flexion  it  desc<'nds  towar'I  the  ti*    1. 

The  funition  of  the  menisci  is  rather  to  form  an  arlii  ular  1  ushion  than  to  sup|)li'n'ent  aiifl  dii'lH'ii  the  artirul.ir 
sot  ket.  In  sonie  positions  of  the  joint  they  ai  t  Imth  as  i  usiiions  and  .is  {Mtrtions  o!  tht  artii  ular  sik  kct.  in  other  nosili*»ns 
thcv  at  t  onlv  as  cushions,  .mil  in  still  others  'licv  exert  no  influenie  wh  never  U|«>n  the  methaiii>i.i  of  ihe  joint.  Durine 
soni','  of  the  movements  of  the  arlitulaiion  1      v  arc  m.irkttllv  ili^plated  or  strongly  n.mprcM'il 


!   I  -> 


THE  ARTICULATIONS  Of  THE  TIBIA  AND  FIBULA. 

The  til)ia  anl  libuhi  art  tdiinriud  '.\iih  cnii  other  in  ilirn  \va\s:  their  u]iper  extreniiiii's 
iirticiilate  liv  means  of  ;i  snidl  joint,  the  tibio/ihular  dilii  uhilion;  the  Ixulics  of  the  lx)iies  are 
(oniUiled  'jv  tile  inter(issei)ii!<  mimbrane:  ami  llie  lower  extremities  are  united  by  tense  ligaitients, 
forming  the  tihio/ihuliir  ^y.ultsmosis. 

The  libiiijihiiiiir  ,irl'u  ulalinn  (l'"igs.  217,  Ji8,  220,  and  22},)  is  the  joint  between  tiic  liluilar 
ani(  ular  surface  of  the  tibia  and  tiie  c;'i)itular  articul;i,  siirlace  ol  tlie  libuhi.  It  is  an  arlhrodiuna 
with  altnost  iilane  arliiular  surfai  vs  and  ])ossesses  strong  aicessory  ligaments,  which  reiL^Jree  the 
capsule  anteriorly  and  ])osterit)rly  and  are  known  ;is  the  anterior  and  posterior  ..v'tulcr  lit^a 
mrnls  (Figs,  ji.''',  220,  ;ind  22,^).  'I'he  tense  ea])Stiliir  I'gamenl  snagi\  embraces  the  .  tilagirious 
surfaces.  Tiiis  artit illation  may  occisimi.illy  commiinicat..'  with  the  knee  joint  (through  the 
popliteal  bursa  1. 


' 


Tmnsxrrsc  lia;iimeiil 
AiUirior  iTuciul  Ihvp  infrupatellar  bursa 

lis-  ^^^Bi^^to-        I'litMir  lis 

Internal 
meniscus 


\ntirior  ni/iilu/iir  lisiinienl 


/  \iiit>,i! 


nuinlininr 


i  il  I 


?  .:■ 


fill 


L-4M-  «»  V 


>  .t« 


iTld^. 


THE   JOINTS    AND    LIGAMENTS   OF    THK    FOOT. 


137 


The  interosseous  membrane  (P'ig.  22,^)  resembles  the  iiucrosseous  membrane  of  the  forearm 
very  closel;  and  extends  between  the  interosseous  ridf^es  of  the  two  tones.  It  eonsists  ehietly  of 
obhque  fibers,  the  majority  of  which  run  downward  from  the  tibia  to  the  l'ilnil:i,  aUhoUf^h  some 
l)ursue  a  course  at  right  angles  to  this  direction.  Its  upptr  portion  contains  a  large  foramen  for 
the  passage  of  blood -vessels. 

The  lihio/ihithir  syndesmosis  (Figs.  223.  224,  and  220)  is  situated  between  the  fibular 
notch  of  the  tibia,  which  is  not  covered  by  (artilage,  and  the  internal  surface  of  thi'  external 
malleolus.  It  is  formed  by  two  ligaments,  rii  ii  in  elastic  fibers,  the  anterior  and  posterior  lii^a- 
ments  oj  the  external  malleolus  (tibiofibular  ligaments)  (Figs.  225  and  22f>l,  which  are  situ. .led 
ujwn  the  anterior  and  ])osterior  surfaces  of  the  lower  end  of  the  two  Ijones.  They  pass  obli(|uely 
downward  from  the  tibia  to  the  libula  and  are  made  tense  when  the  broader  jxirtion  of  the  sujKTior 
articular  surface  of  the  talus  (astragalus)  enters  into  the  articular  socket  of  the  ankle-joint.  The 
lower  ends  of  the  tibia  and  libula  may  conse(|uently  be  passi\ely  se|)arated  for  a  certain  distance; 
this  is,  however,  practically  the  only  movement  between  the  tibia  and  libula. 


THE  JOINTS  AND  LIGAMENTS  OF  THE  FOOT. 

The  joints  and  ligaments  of  the  foot  will  be  considered  separately,  since  many  of  the  ligaments 
of  the  foot  l)elong  to  several  joints. 

THE  JOINTS  OF  THE  FOOT. 

The  joints  Ix^tween  the  talus  (astragalus)  and  the  bones  of  the  leg  and  those  between  the  indi 
vidual  bones  of  the  foot  may  be  divided  into  the  following  gr(.ui)s: 

I.  The  Artieulations  oj  the  Talus  {Astraf;alus),  which  include  the  taloerural  artieulation 
(the  ankle  joint),  tiie  taloealeaneal  artieulation,  the  taloialeaneo  navieular  artieulation,  and  liie 
calcaneoeuboid  artieulation. 

2.   The  tarsal  Arlhrodia. 

(a )  The  intertarsal  artieulations  1  the  euneonavieular  artieulation). 
(/))  The  tarsometalarsal  joints  illie  tarsometatarsal  and  inlermetatarsal  artieulations). 
(■),)  '\'\n-  Joints  oj  till    'rorstiUrmitalarsoplialaufieal   am]  <lii;it,il  \interplialane.ial :  arliiula- 

tionsi. 

The  ankle  joint  or  taloerural  artieulation  (  Figs.  224  and  22(>i  is  the  joint  Inlween  the  astraga- 
lus an<l  tile  two  bonoof  tile  leg.  The  articulating  surfaces  are  the  trochiia  of  liie  talus  ujion 
the  (me  han.l,  and  the  inferior  articular  surface  of  the  tibia  and  the  articukir  surfaces  of  ihe 
internal  and  external  malleoli  upon  '.he  other. 

The  articular  ca))sule,  which  surrounds  the  cartilaginous  surfaces  and  is  inserted  toward  the 
neck  of  the  astragalus,  is  thin;  its  anterior  and  esjiec  ialiy  its  lateral  portions  are  rather  tense,  while 
the  posterior  portion  is  roomy  and  relaxed. 

I- nun  il^  inn.  li.in  .in. I  in  ^i. .  .T.l.in,  .•  with  Ui.-  f.irin  ..f  ih.-  artiml.ir  -url'.n.>,  tli.'  i.ilm  rur.ii  .irii.  ul,iti"ii  i-  :\  liinn.- 
j..int,  Ihr  siKki-l  i«f  wlii.  h.  li.nMM-r.  i^  f..rnu-.l  In  !«..  In.nis.  A^  tin-  syml. -.ni..>.i^  (.mni'itini?  tli.  lil.i.i  .in.l  llif  (ilml.i 
il.K's  n.il  at)S<)lutc-lv  |iri.lii.l.-  ni.>li..ii.  \\w  l>r.>.i.l  aniiri..r  p.irli.in  ..(  Ih.    Ir.Hlilr.i  ..(  tin-  lalus  ..in  li.   a..  i.nini.j.ialc(l  by  a 


f: 

i  \ 

} 

1  '  !'n 


138 


ATLAS    AND   TEXT-BOOK   OF   HITMAN    ANATOMY. 

j.-j(-    224  _The  anklc-juim  seen  from  liehind  (}). 

F,,-.'  2^, .-Horizontal  frozen  section  through  the  tarsal  articulatmns  (J) 

Vu!'.  a^l-Frontal  frozen  section  through  the  ankle  and  ,.o.ter,or  talocalcaneal  jomts  (i). 


.,Ht  sepa.u>„n ..  .H.- ... .. ..  u.;  .n.,  .v.n  .He  n-.  ^,;;:^^';:r;:::z^::r::  ciZu.  'T;:i: 

dorsal  flexion. 

The  talocalcaneal  articulation  (Figs.  225  and  226)  is  the  joint  between  the  convex  posterior 

r     h     r^  tee  of  the  calcaneus  and  the  concave  posterior  calcaneal  art.cular  .urface  of    he 

arucular  surface  of  ^^^  -^';  ^^^^       ^i„„,  „{  ^he  surface  of  a  cone,  the  axis  of  wh.ch 

"'t^Z  "d   ..u^-  ^^^vhat  obliMueK  upward  and  forward.     The  articular  capsule 

Tnd  .^hx  This  articulation  occasi<,nally  communicate^  with  the  ankl.-jomt 

■^  'H  i:  r  :  J!:^/..  ^^rticulation  ,Figs.  ..,  and  .30)  is  U.e  Joint  ..rmed  h,  the  head 

f  .t         .    s      s,r-.g-.lus   the  anterior  and  n,iddle  articular  facets  of  the  calcanetis,  the  po.  er  or 

.  ",  r t    t'   n  w  ".dn^ar,  and  the  navicular  hhn,cartilage  of  the  plantar  calcaneon.tvuular 

;  e  ,    .      I  j'.in>  i^  ^'  pronouncedly  compound  articulation,  and  includes  an 

l:^::ZXl,.^.  ';ro...her  wi,h  .he  talonavicular  joint,  it  forn,s  the  transverse  artuulat.n 
o]  the  tarsus  (C'hopaM's  joint). 


i-  ,1...  rln,  .«.,.,,.„  ,h.. .-,.«aluM  a,.,l  ,1.;  nav,,  u.ar  ...,,,«,.        -     ;«    ^^  "      ,  '         ,„ .„,.  ,,,.  ,,,.,,„, 

„„,    \,  „  ,„  .,|,,.„„lal  i..in..  »hil.-  .1.,.  ,al.,n.n„ular  ar,„ula  ,         .  a       ■  •     ^ «^^^^^_^^_  i_    _^^^^  ^^  ^^^_^^_^  ^__^ 

„„„  ,,„..W  ,,„!,  ,.-iur  n..i,,r.„ailv,  >„  .1 lur,„«  n,u, ;',;;„  ],  ,„,  ,,„,„.,,„, ,...„„,  j ..,  „ 

-.."-  -"'  ""■  '■■'■»:": -'/■""■        :,  :a:r:l;  i  u     ::    in  aU.,  a,,  ..>..!.. .....  in,,..  ,nar« f 


i! 


,„  „.„ ,., ., a,i >;:::;,::i:.::r::.h.,..,„...a,  a..ia,i,.,.„ ,. ,...  *.,.-....  au....... ..i,T...n,,  a- 1,  a,.. 

Th..  ..rthrodi.  of  .in.  ,ar.u>  coumM  of  a  variaLI.  number  of  .ingle  or  combine.l  articulations. 
....::;;:;;;;n::r,i.u,ar.avi.iesfre.,t.en,bint.co,™ 
f,.ets  i.  relativelv  large,  the  numlHT  of  joints  .s  con.p.natnih   smail  biuivi.e 
,rti.  id  ,r  facets  ,.o  not  all  form  in.lependent  artindalions. 

';:. .-'» j-:'-?::.;;  ;:r,i;:;i,;r  ;:'::;„:;:::"  r:;:»t::;: 


Tibia 


Infnvs^nvis  Mrfn-       Intero^^     AUtararsai  III 

M.taUinal  nineo-meUi-  tuntil  It      ^rous 

hon,-  of      """'^  ^'^-  bii^iUli}:. 
liiii't  roe 


larsottu-iiitatsaf 
arliaiUuion  It-Ill 

Mefii- 
tan>at  IV 


Ttirsometatnrsn! 
jiunt  of  ^ivtit  rot' 
Int.  inniif'onti 
hone 
Po^forior  /a-. 
of  rxtfrnal 
malleohis 

Inft  rossfoim 
tntvirunei- 
form   lig. 
Po^mior 
tulo-fihiiliir 

(  iint'o- 
tjitviailnr  art. 
P(f>tinor  fti/o- 
ailitifirn!  litf. 

Stiviiuliir 
hone 
(  nfainro- 
fihular  ii^. 


Inlonnvinthr 
iirtnuUnnni 


Ciitiartio- 
nif'Ofti 
arfic- 


Fig.  224. 


('oliuneal  icni'on 


ttilO'inlntnOtl  V 


f  \lirmil  nuilU'o'tits 


f'lhulii 


In/'iiior  tirfitnlor 
I  thus         \urf(H-f  of  tihui 


Tolo-oilitinrn 
arfiiuliition 


Aitiniliir  ^nrfiii 
01  mtillfOlii 


Ih/roiti  li^timcnf 


ruliU'intl  umion        f'<'f""""'i 


/tlr,  225. 


/\'^tfnoi  fiilo-oilnvi-  :! 
ailhiittition 


I  io.  J'JO. 


tft\or  diiiitoiwn  hnvf^ 
t'tilnt'im^  I  otm  fi/u/rlin  li^ttnttuf    ■ 


i:!l 


Tlir   JOINTS   AM)    I.ir.AMKNTS   OK   THE    FOOT.  139 

surface  of  the  cuboid  and  the  corresponding  surfaces  of  the  navicular  and  ex(ernal  cuneiform 
bones.  The  joint  also  usually  communicates  between  the  internal  and  middle  cuneiform  bones 
with  the  second  tarsometatarsal  joint,  and  is  c()nse(|uenily  a  very  complicated  articulation. 

The  Uirso-mdalarsal  arlkulation  (Lisfranc's  j(iinl)  (Fig.  225),  logethi'r  with  the  hilcr 
mctalarsal  articulations  t  l'"ig.  225),  form  three  sei)arate  joints:  one  connecting  the  metatarsal  lx)ne 
of  the  great  toe  with  the  internal  cuneiform  bone;  one  connecting  the  ba.ses  of  the  second  and 
third  metatarsal  bones  with  each  other  and  v  ith  the  middle  and  external  cuneiform  l)<)nes;  and 
the  third  connecting  the  fourth  and  fifth  metatarsal  lK)ncs  with  the  culx)i(l  Ixme.  Thi  line  of  Lis 
frani  's  joint  has  its  most  ])roximal  point  at  the  inner  margin  of  the  sole  of  the  fool  and  its  most 
distal  point  at  the  base  of  the  second  metatarsal  bone,  so  that  a  dee|)  indentation  is  jjresent  in  this 
situation.  From  this  point  the  joint  line  jnirsues  a  markedly  distal  direction  and  then  makes 
a  distinct  curve  toward  the  proximal  portion  of  the  foot. 

The  miivcmcnts  in  thi'  tars,il  .•>'lhroiiia  .ire  ixtrcmcly  sliglu,  sin<i-  numi  rous  IciT^c  ligaments  limit  thi'  rangr  i)f 
niutioii  vtTv  ic)nsi(l<ral)ly.     The  slight  n'.ovrmcnts  whic  li  arc  pussihlc  su|i|ili'nn-nl  tin-  ihii  f  iivvcnunls  nf  the  fiKU. 

The  nutatarso- phalanf:,cal  and  the  digital  [inter phaUuii^cal)  joints  reseml)le  the  corresjjonding 
joints  of  the  hand  with  .slight  variations.  The  mei..tarso  ])halangeal  joint  of  the  great  toe  in 
particular  exhibits  a  special  mechanism,  as  two  large  st'samoid  bones  are  imbedded  in  tiie  plantar 
surface  of  its  cajisular  ligament  (see  j)age  io())  and  transform  the  articulation  into  a  .speeio  of 
hinge  joint.  .\  further  ])eculiarity  is  the  marked  dorsal  extension  of  the  artic  ular  -urfaces,  i>ar 
ticularly  those  of  the  second  to  the  fifth  metatn  a!  Ixmes,  which  permit  of  a  hy])erextrn-ion  (dors;d 
fk'xiim)  )f  the  toes.  These  articulations  also  resemble  hinge  joints  more  than  arthnKJia  iginglymo- 
arthrodial.  Ossification  is  freipiently  observed  between  the  indi\idual  phalango,  particularly 
in  the  little  toe.  The  accessory  ligaments  of  thesi-  joints  are  similar  to  tho>e  of  the  han<i  ilrans- 
virsf  capitular  (I'igs.  228  and  229),  accessory  plantar,  ami  lateral  ligaments). 


THE  LIGAMENTS  OF  THE  TARSUS. 

The  ligaments  of  the  tarsus  (I'igs.  224  to  2;,o)  may  be  subdivided  intn:  '\>  Tht  liga- 
ments lit  the  ankli'  joint,  <  2I  the  ligaments  betweiii  ilie  astragalus  and  t'.e  ealcane  is,  ;;  j  the 
dorsal  tarsal  ligaments,  14)  the  plantar  tarsal  ii^aments,  and  i;;  the  inlernsseous  larsil 
ligaments. 

The  ligaments  of  the  ankle-joint  (Figs.  jj4  ^md  22(1  to  22S1  canned  tlie  Imnes  nf  du  leg 
with  tin-  laliis  (asiragalusi  and  the  calcaneus,  and  ptn-ue  a  more  or  less  \  eiiiial  ilireitiim.  I'.aih 
of  the  iwo  malleoli  is  connoted  with  the  neighboring  tarsal  bones.  The  lidloiit  liiianun'  1 1'ig. 
2271  arisi's  from  the  intirnal  malleolus  aiul  radiates  to  the  lalu:  lastrai^alusi,  the  cah.ine'iN  and 
die  naviitdar  Inine.  It  is  narrower  at  its  nrigin,  hroad  at  it  -  inserdoti,  and  is  mmpo-e'i  .it  tour 
separate  ligaments:  the  anterior  talo  tiliial,  the  posterior  lalo  tibial,  the  cahaneo  til  ial,  .,n^  ihi 
tibionavicular  lifianienls. 

The  anterior  talo  tibial  1 1  .^anient  1  Fig.  227)  ]iasses  to  tlv  antc.or  extreivily  of  the  neck  n|  the 
talus  i.istragalus)  and  is  .ilmost  lomiiletely  covered  by  the  cal'aneo  tibial  lii^amenl  1  Fiu.  .'271 
wiiieii  runs  to  tjie  margin  of  tlie  susleniac  uluiii  laii.      1  he  poslirmr  l-tic  libiai  iii^anh  in    I  ]•:•..    24 


■ 


140 


ATLAS    AND    TKXT-BOOK    OF    HTMAN    ANATOMY. 


tr*^ 


Fi<;.  227.— The  ligaments  of  the  tarsus  seen  from  the  inner  side  (j). 
Flii.  228.— Tiic  ii.naments  of  the  foot  seen  from  alxne  and  from  the  outer  side  (J). 
22Q— The  nj,Mm"nts  of  the  foot  seen  from  the  plantar  surface  (J). 

^30— 'I'lii'  ligaments  of  the  foot  seen  from  the  dorsal  surface.  The  talus  has  been  remo\ed  so 
as  to  show  the  |)artiii|)ation  of  the  navicular  li,i,'ament  in  formini;  llie  socket  of  the 
talocalcaneo-na\ icular  joint  {'{). 


Vu 
Fit 


and  227)  fjocs  to  the  j)()sicri(>r  process  of  the  talus,  and  'he  liliio-iuivicii/.ir  (Fig.  227)  has  its 
insertion  upon  the  dorsiil  surface  of  ihi'  navicular  hone. 

Lij^aments  pass  in  a  similar  nianii.  r  from  the  external  malleolus  to  the  talus  (astragalus) 
and  to  the  calcaneus.  These  are  known  as  the  aiilerior  tiilo-fibuUir,  the  posterior  talo- 
jihiihir.  and  the  Cukanco  fibular  lii;amcnls.  The  anterior  lalo-fibidar  ligamcut  (Fig.  228) 
I)asses  almost  liori/.ontally  from  the  anterior  surface  of  the  external  malleolus  to  the  an- 
terior margin  of  the  trochlea  of  the  talus;  the  posterior  talofibular  (Fig.  224)  pursues 
a  corresi)onding  course  and  connects  the  jiosterior  border  of  the  external  malleolus  with 
the  outer  tubercle  of  the  ])osierior  ])rocess  of  the  talus;  and  the  caleatteojibular  lii^amenl 
(Figs.  226  and  2;;o)  ]iasses  somewhat  ()bli(]uely  downward  and  backward  from  the  tip  of  the 
external  malleolus  to  th.'  outer  surface  of  the  calcaneus.  Upon  this  ligament  run  the  tendons  of 
the  two  peroneal  muscles  isee  i)age  222). 

The  ligamentous  connections  between  the  astragalus  and  the  calcaneus  consist  of  the  rein- 
forcing ligaments  of  the  talocalcaneal  articulation  and  of  the  ligamentous  mass  which  occujjies 
the  sinus  of  the  tarsus,  the  interosseous  lalo-caleaneal  lii^ament.  The  latter  (Figs.  22-i  and  2^0) 
consists  of  a  number  of  firm  fibrous  layers  and  forms  a  s])ecies  of  syntlesmosis  between  the  two 
Ijones. 

The  reinforcing  ligaments  of  the  posterior  articulation  of  the  two  lK)nes  are  known  as  the 
internal,  external,  posterior,  and  anterior  talo  eahamal  lii^aments.  The  external  and  particularlv 
the  anterior  ligaments,  which  bridge  o\er  the  sinus  of  the  tarsus,  are  connected  with  the  inter- 
osseous lig,.ment.  The  external  ligament  (Fig.  228)  pas.ses  from  the  outer  and  lower  su'-face  of 
the  neck  i>f  the  '■  lus  (astragalus)  to  the  upjter  surface  of  the  calcaneus;  the  anterior  ligament 
connects  the  lower  surfaie  of  the  talus  (astragalus)  with  the  ujjper  surl'aie  of  the  calcaneus;  the 
IK)sterior  lig-.ment  connei  is  ti:e  outer  tubercle  of  the  jjosterior  process  of  the  talus  with  the  u])per 
surface  (tl  the  cahaneus;  and  the  very  narrow  intirnal  liganiint  i)asses  from  he  inner  tuber- 
cle of  the  i)osterior  pnn-ess  of  the  talus  to  the  sustentaculum  tali. 

The  dorsal  and  plantar  ligaments  of  the  foot  are  practically  hori  ontal,  and  are  composed 
partly  of  transverse  and  partly  of  longitudinal  fasiiculi  which  lonnect  niiiihtxiring  bones  and 
i(>nse(|uenlly  reinforce  the  arlicidar  (apsules.  The  plantar  ligaments  are  considerably  the 
strong!  r,  and  some  of  them  conned  ibstant  portions  of  the  tarsus,  passing  over  one  or  even  more 
lx)nes. 

The  dorsal  tarsal  ligaments  are  tho>e  which  connect  the  talus  (astragalus)  and  thecal 
(aneuswiih  ihe  t.avii  ular  and  ihetuU.id  l)<)nes.     They  are  the  f/cr.w/ /(//o-mnvrHA/r //(,',;>«(■«/.  the 
ilorsal  I  aleaneo  naiieular  lit^a.nent,  and  the  bijureate  lii^ament.     The  bi'jureate  ligament  ( Fig.  228) 
connects  tiie  antero  internal  angle  ul  the  calcaneus  with  the  dorsal  surfaces  of  the  navicular  and 


■r.- 


Tfl 


|ii 


I 


Of- 


i 

■  ■7    ^-n 

1  i 

■   ^1 

i  ' 

i 

:i 

I 

;1: 1 

i 

i        i 

■  1 

I  Mi 

:  J 

■   ii 
1 

i  h- 

m    I 


I  I 


N  !  1 


Tninsverse  capitular        Mct,itarso-/>liiilaai:eal 
ligaments  aiiiailiitioits 


I  I'll g 
/ilaiiliir  Hi 


leiidon  of  /moiiaeiis  loiiiiiis 
]        /'Iciiiliir  tdrsaiiii'idt.irsai  //,    • 


rimttnr  niiiit'iiliin- 
nine'ltfrrii  It^jtni'nts 


Dorsal  tarso-iintalarsal 

r       /iu'llllll'lltS 


Oor^itl  ntivitn/iin 
ainrihn-iil  lix''' 


fir.  220. 


Aruniliiy  UitTt  .'(  luivinil.ir  l\'ne 

Navicular  Jihrocartilag;i' 


Miihlh-  articular  facet  of  calcaneus 
lircrasscous  talo-calc.iiical  li^aunut 
Anterior  articuUir  facet  of  calcaneus 

I'aslerior  articular  facet  of  calcaneus 


Dorsal 
iineocul'oid 


Dorsal 
c.ilaneo- 
cuhoiil  Hi;: 

icudon  of 

/leroiiaciis 

hri\'is 


/7^,^  230. 


Uli 


n 


^  I 


THK  JOINTS   AND  LIGAMENTS   OF   THE   FOOT. 


141 


cuboid  bones;  it  necessarily  divides  into  two  portions,  one  for  each  bone,  known  as  the  cakaKco- 
naviciilar  and  the  calcaneocuboid  portions. 

The  navicular  is  connected  with  the  cuneiform  bones  by  the  three  ,iorsal  mnicuhirnmn 
jorm  ligamaits  i  Fi-.  228).     The  first  of  these  is  the  broadest.     The  cuboid  an.l  navicular  Ih.ihs  are 
connected  bv  the  dorsal  cuhoideo-navicularlijiamcnt  (Fig.  228);  the  cuneiform  bones  are  connected 
with  each  other  by  the  dorsal  intcrcumijorm  ligaments  (Fig.  230);  an.l  the  dorsal  euneoeiihoid 
ligament  (Fig.  2  -,o)  runs  between  the  external  cuneiform  and  culjoid  Ijones. 

The  connection  between  the  bases  of  the  metatarsal  lK)nes  and  the  tarsal  bones  is  elTected 
bv  the  dorsal  tarsometatarsal  ligaments  (Figs.  228  and  2,^0);  the  bases  of  the  metal;  rsals  are 
connected  with  each  other  by  the  four  dorsal  basal  ligaments  (Fig.  228). 

The  plantar  tarsal  ligaments  maintain  the  normal  arch  of  the  foot.  By  far  the  largeM 
and  strongest  of  them  is  the  long  plantar  ligament  (Vi'A^.  22A,  227,  and  229),  which  is,  in.l.ed.  one 
of  the  strongest  ligament>  of  the  Ixxly.  It  arises  from  the  entire  lower  '.urface  of  the  eali  an-  11  m 
front  of  the  tubercles  of  the  tuberosity,  its  width  almost  entirely  covering  the  In.ne,  and  ii  .  i  nng 
longitudinal  fasciculi  are  inserted  into  the  tuberosity  of  the  culx.id.  From  the  main  n^  ot  the 
licrament  there  are  given  otT  superficial  fasciculi  which  jiass  over  the  tendon  sheatli  m  the  pen. 
ncus  longus  situated  in  the  culx^id  groove,  and  extend  to  the  base,  of  the  outer  metatarsal  Ix.ncs 

(secpage227,  Fig.  312).  .     ,     ,.  ,    ,- 

The  second  strongest  ligament  of  the  tarsus  is  tiie  plantar  calcaneonavicular  ligament  ( !•  igs. 
-7  and  229),  whose  strong  fibers  i)ass  obliiiuely  between  the  sustentaculum  tali  and  the  na\ic 
elar  Iw.ie.     The  dorsal  surface  ot  the  ligament  is  covered  with  cartilage  and  contains  the  nam  u 
iarfihroc Milage  (Fig.  2,^0),  which  forms  a  jxirtion  of  the  socket  for  the  head  of  the  talus  (astrag- 
alus) (see  ,)age  i:,8).     Upon  the  dorsal  surfa. .   of  the  loot  tliis  ligament  is  connected  with  the 
tibio-navicular  ligi-ment. 

The  plantar  ilcaneocuhoid  ligament  is  adherent  to  the  dorsal  surface  ol  \hv  long  j.lantar 
h-ramenl  and  reinforces  the  i)lantar  surface  of  the  artirular  caj.sule  of  the  calcaneocuboid  joint. 
The  navicular  ami  the  cuneiform  bone^  are  connected  by  tlie  plantar  navinilarieaneijorm  liga- 
ments (Figs.  227  and  2;o);  the  culx.id  am'  the  navicula.'  bones  by  the  plantar  euhoideo  navicu- 
lar ligiment  ('-ig.  2^o);  the  cuboid  and  th.;  eMernal  cuneiform  bones  by  the  plantar  cuueo  cuboid 
ligament:  and  tl"  ■  three  .■vmeif..rm  bones  with  each  ..ther  by  the  plantar  intercuneijorm  ligaments. 
■[■here  are  a!>o  plantar  larso  metatarsal  ligaments  and  three  plantar  basal  ligaments.  -Aliieii  pursue 
a  similar  course  to  the  corresj.om'ing  dorsal  ligaments. 

The  interosseous  ligaments  are  those  ligaments  o.  the  foot  wliiili  are  Mtnated  neither  up<.n 
the  dorsal  nor  the  j.lanta,  surface,  but  which  connect  contiguous  surfaces  (.f  tfe  tarsal  (.r  -netalar- 
sal  bones  in  those  situations  where  no  articular  connection  exists.  Thex'  really  represent  syn.ks 
imses,  and  are  found  onlv  between  those  bones  which  move  ujion  eac  h  (.ther  but  slightly,  if  at  all. 
In  additi..n  to  the  previ<.usly  mentioned  interosseous  tal-.calcaneal  ligament  (Figs.  22(,  and  2,^01, 
these  ligaments  are  tlu'  interosseous  cuneo  cuboid  ligament,  i\k-  interosseous  intercuneijorm  liga 
ments,  the  interosseous  ciineo  metatarsal  ligaments  , particularly  between  the  internal  cumif<.rm 
and  the  base  (.f  the  seconr  ctatarsal  bone,  where  an  interosseous  basal  metatarsal  is  wanting  1, 
and  the  inieross.ou.  i>u.ui  nutaiarsa!  ligamrnts.  The  uj>i.er  and  lower  surfaces  of  some  of  these 
ligaments  are  in  direct  ..ontacl  with  the  cor  .sponding  dorsal  and  plantar  ligaments. 


li'.ili 


l-'i 


I  t 


Hi 


i  I  i 


W  i 


MYOLOGY. 
GtNERAL  MYOLOGY. 

.Myolo<rv  is  the  study  of  the  nuisdus  and  of  their  arresson-  stmctiiies,  such  as  tendons, 
aponeuroses,  fasciie,  intermuscular  septa,  tendin-  is  arches,  pulleys,  mucous  hurs;e,  tendon- 
sheaths  {vaj^irue  mucosa-),  tendon  relinacula,  and  sesamoid  lK)nes. 

The  musculature  of  the  human  Ixxly  occurs  in  two  forms  which  present  both  hi.tolojriial  and 
physiological  differences  (see  "Atlas  and  Epitome  of  Normal  Histolo,i,'y,"  Soboita  Huber).  The 
actual  skeletal  muscles  are  composed  only  of  striated  muscular  tissue. 

The  muscles  form  the  fleshy  jiortion  of  the  b(xly,  and  are  contractile  structures  which  vary 
considerab!'.  in  size  and  shape.  A  typical  muscle  is  composed  of  a  muscular  brily,  whicii  forms 
the  greater  jiortion  of  it,  and  of  two  ends,  one  of  which  is  known  as  tiie  orifiin.  or  linul,  and  the 
othcT  as  the  insertion,  the  origin  beir  that  end  which  is  attached  to  the  usually  more  fixed  i)ortion 
of  the  skeleton  and  the  inserion  lh:u  attached  to  the  more  freely  movable  portion,  ijut  the  i)hysio- 
logical  relation  of  origin  and  insertion  may  be  reversed.  .\s  a  rule,  both  the  origin  and  the 
insertion  ])ossess  a  tendon  of  varying  length,  which  is  usually  con>iderablv  tliinner  than   the 

muscle 

Muscles  are  distinguished  according  t..  their  sha].es.  A  great  many,  jiarticularh"  those 
forming  the  mass  of  the  extremities,  are  fusiform  or  si)indle-shaped,  while  others  are  broad,  thm, 
and  llat;  muscles  whose  length  but  slightly  exceeds  their  breadth  are  designated  short  muscles. 
Some  musdes  surround  orifices  of  the  Ixxly  or  canals,  and  their  fibers  are  circularly  a, ranged: 
they  are  known  as  orbicular  musclrs.  or,  if  they  serve  to  close  orifices,  such  as  the  mouth,  for 
exam])ie,  as  sphincter;-.  Those'  muscles  in  which  the  fasciculi  pass  to  a  tendon  develojied  at  the 
side  of  the  muscle  are  known  as  jiinnale  or  jjcnniform  muscles,  and  if  the  tendon  1k'  situated  in 
the  middle  and  receives  muscular  fasciculi  from  either  side,  the  muscle  is  said  to  be  bijjinnate 
or  iji])enniform. 

The  majority  of  the  muscles  have  a  single  head,  but  occasionally  two,  three.  ■'-  four  heads 
unite  to  form  a  muscular  belly,  producing  a  biceps,  triceps,  or  (|uadriceps  muscle.  A  muscle  com- 
posed of  two  bellies  with  an  intervening  tendon  is  termed  a  biventer  or  digastric  muscle. 

If  mu.scles  pass  only  over  one  joint  of  the  body  (particularly  in  the  extremities),  they  are 
known  as  monartir  ''-.r  muscles;  if  they  extend  over  two  main  joints  in  their  course,  they  are 
called  biarticula 

Tendons  occur  in  connectioi,  with  nearly  all  the  muscles,  and  are  comi)letely  aljsent  in  the 
sphincters  onlv,  though  partly  wanting  in  the  orbicular  muscles.  Every  muscle,  however,  has 
not  a  tendon  at  both  ends,  it  freiiuently  hapjx'ning  that  onh  tiie  tendon  of  insertion  is  develoiied, 
while  the  origin  is  purely  muscular.     The  fibers  of  the  tendcms  of  origin  or  insertion  are  \ery 

Mi 


t'ral  r. 

slenioi'liiiloiiuislciiil 
I  (I  I, nil  irrvicdl  /'• 
ii/)rmi(iriailiir  /'. 
cliivinilcir  r. 
iicioiiiiiil  r. 
iilnici.iviiii!iir  r. 


nil     u!  rr. 


external  rninti  r. 


internal  rrnral  r. 

internal  retromallevlar  r. 
internal  mu'leotar  r. 
caleaneal  r. 
digital  rr.  of  loot  - 

lingual  rr.  - 


(1 


FifT.  231.  Regions  of  the  human  body. 


yJLJSSi 


auricular  r. 
fovea  imchac 


acromial  r. 


external  cnliitnl  r. 
posterior  eahilal  r. 


external 
brachial  r.  - 

internal 
brachial  r. 

external 

cubital  r. 
olecranal  r. 

posterior 
cabital  r. 


volar 
digital  rr. 

external  femoral  r. 


txttrnni  crural  r. 


extrrnul  retromalleolar  r. 


\lor\ol  of  fool 
cali-ii'cal  r. 


fifr.  212    Regions  of  the  human  body 


h, 


i 

! 

I 

i       « 

■ 

■        1 

f  j 


m 


superior  palpebral  r. 
in/trior  palpebral  r. 


superior  labial  r. 
inferior  labial  r. 


auriiitlar  r. 


V 

pnal  r        / 

/   /i's\/7    ■iiiprnibu'inibir  lowU 


/ui;iilar  Iowa 


/lir.Jii.    Regions  of  the  head  and  neck. 


! 

f     i 


li 


perineal  regions. 


ruf 


/vff.  234.   Male  perinviin, . 


f-'iiv     '2.'\^       f't'nUlli'    !}i*!'!!ii'!i!!! 


If    r- 


GENERAL   M\'OLOGY. 


143 


frequently  mixed  with  mu^cuiar  fibers,  so  that  neither  a  purely  muscular  n<,r  a  purely  tendinous 
origin  or  insertion  exists. 

The  spindle-shaped  muscles  have  cylindrical  and  frequently  very  long  tendors,  hut  the  tlat 
muscles  usually  arise  by  means  ■  '  f.attened  tendons  which  are  known  as  ti/xnicdosi's,  and,  mi 
the  cases  of  the  tlat  muscles,  may  serve  as  fasci;e  for  other  muscles.  The  round  tendons  also 
occasioiiallv  form  aponeuroses  in  the  vic'nity  of  their  insertions. 

Broad  tendino>>.s  i)lates  are  sometimes  found  u])on  one  of  the  surfaces  of  a  muscle  in  the 
middle  of  its  course,  and  a  musde  may  ]>ossess  ;[  lumber  of  tendinous  interruptions,  arranged  at 
more  or  iess  regular  distances  from  each  other;  these  are  termed  Inidiiwits  iiiscriplions. 

The  jascict  are  connective-tissue  coverings  which  surround  indix  idual  muscles  oi  groui)S  of 
muscles.  They  are  fre<|uenlly  adhere.it  to  their  muscles  and  form  their  aponeuroses,  an(i  are 
especialb-  well  develo;)efl  in  the  extremities,  where  they  form  a  common  sui)erticid  >hcalh  for 
all  of  the  muscles.  Some  muscles  do  not  possess  fascia-,  as,  for  example,  the  muscles  sudated  in 
the  skin,  such  as  the  i)]atysma  and  the  majority  of  tlie  facial  muscli'< 

The  inlcrmisciihtr  s.'pla  are  intimately  connected  with  the  fascia-,  biing  sheet  like  prolonga- 
tions of  those  of  the  extremities,  extending  to  \\\c  i)eriosieum  so  as  to  f<irm  jjartitions  helwttn 
groui)S  of  muscles  having  ■    similar  function  (synergists*);  they  f-c'iuently  also  give  origin  lo 

muscles. 

The  Irmiiiwus  arclir.:  are  iigamintous  bands  whiih  bridge  over  vessi'ls  or  nerve-  and  i)ro- 
tect  them  as  thev  i)ass  through  a  muscle;  they  may  also  pass  between  wo  neighlioring  bones  and 
furnish  a  sujjport  for  muscular  )rigin. 

Pulleys  or  trochlea  are  for  the  jjurpose  of  giving  the  tendon  of  a  nni  .de  a  different  dir  .  tion 
from  that  of  the  liellv.  'I  ■  tendon  retimiiula  operate  .n  a  similar  manner,  and  are  found  chielly 
in  those  situations  whc.  .'tidons  run  in  a  bony  gr(;ove.  They  hold  tlie  tendons  lirmly  m  the 
channel  and  prevent  their  displacement;  a  similar  function  is  served  by  the  V(ii;in(il  liti<imenls 
which  maintain  the  tendon-sheaths  (sic  below  1  in  ])ositi(-n. 

The  mucous  hursce  are  thin  walled  cavities  lillcd  with  a  lliiid  similar  to  that  of  the  synovia 
of  the  joints.  They  are  found  where  muscKs  or  ten(h)ns  i)ass  over  l)ony  i)romininct.,  or  where 
tendons  are  inserted  into  a  Ijone,  and  serve  to  prevent  fricti(m  l)etween  the  mi  scles  and  tnidons 
and  thelK)ne.     They  are  fre(|uentlv  divr-ticula  of  the  synovial  membranes  of  tiie  join-- (see 

page  108). 

The /(■))(/()«  ,v/(('<;///,v  or  T(;,i,'/mr  m//((»\rf- act  in  a  similar  manner;  they  surround  the  tendons 
of  tlie  muscles  of  the  extn  mities  (jjarticularly  in  the  hand  and  foot)  for  a  lerlain  distance,  ami  pro- 
tect the  tendons  from  friction  during  action.  They  :u  i)artly  protected  by  retinacula,  and  partly 
hy  vine  ulii. 

Sesamoid  hones  are  mechanical  aciessories  of  the  tendons  in  which  they  are  usually  embedded. 
They  are  not  necessarily  bony  but  are  often  only  librocartilagitious,  and  serve  the  puri)ose  of 
increasing  the  working  angle  of  the  tendons  and  of  m  iking  it  jiossible  for  the  tendons  to  glide 
over  the  joint.     The  i)atella  (see  page  .)<))  is  the  largest  sesanioi<l  l)one  of  the  Ixxly. 

The  stri.il.d  niusc  ulalun-  u(  tin-  I-kIv,  with  f.w  cxi.iuiims  ariM-*  fr..m  llu-  my.)tonH.i  nl  the  t.irs.iii.-rnii,    s.mimi,-. 
Till-  musi  lllatun-  of  the  Irunli  aris.s  .lircdtv  from  lli.s,-  <lrii.lur.-s  ami  it-^  scKmrntal  arr.iiimnu-ni    .  ..rr.s|).iniliiiR  lo  it; 
*  Mii-ii  Un  having  opiHjsilr  fun  t;.  ns  an'  irrmcil  aiilanonisU. 


1 


Mi  j. 


144 


y^T^AS    AND    TEXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  236. — The  superficial  layer  of  the  flat  muscles  of  the  back  together  witH  the  neij;hboring  muscles 
of  the  head,  neck,  abdomen,  and  buttock. 
Upon  the  riglu  side  the  rhomlxjiduus  major  and  the  teres  major  are  re])resenied  covered  l)y  fa.ii  ia. 


origin,  ean  usually  In'  distinctly  recognized  in  the  dee]>er  layers  of  the  muscles  of  the  back  and  nei  k.  The  muscles  of  the 
alidomen  and  of  the  extremities  arise  seccmdarily  from  the  myotomes.  In  man  the  musculature  of  the  extremities  is 
very  strongly  develipped  an<l  eover^  the  entire  dorsal  anil  part  of  the  ventral  musculature  of  the  trunk. 

[In  the  following  pages  the  cla.s.silkati(m  ado])te<l  for  the  muscles  is  a  topographical  one,  an  arrangement  which  Ix'.st 
accords  with  a  itlas  ilesigned  .as  an  aid  for  the  lalxiratory.  Such  a  classification,  however,  is  in  many  cases  faulty  in  that 
it  fails  to  ])rcseni  the  true  morjihological  relations  of  the  mu.scles.  sometimes  grouping  together  musi  les  whic  h  have  entirely 
dilTerent  morphological  values,  and  sometimes  separating  in  different  grou[)s  musi  les  whic  h  in  reality  are  closely  related. 
.\t  the  close  of  each  section  where  it  seems  necessary  there  will  be  found  a  brief  mori)hological  classification  of  the 
muscles  c)f  which  it  treats. — Kd.J 


i     II 


SPECIAL  MYOLOGY. 
THE  MUSCLES  OF  THE  TRUNK. 

THE  MUSCLES  OF  THE  BACK. 

The  muscles  of  the  back  are  arranged  in  layers  and  extend  throughout  the  neck,  the  back, 
and  the  lumbar  region.     The  muscles  of  the  individual  layers  may  Ix'  advantageously  grouped, 


Lumbar  vertebra 

r 


Obliquus 

abdominis 

Tratjnrrsus  alnlnminis     inirruwi 


rtitr  layers  nj 


Kic;,   217. 


I.iimtni-dttrsal  jasda     Lcn^  mt'scles  Lunthn-diirsal  Jiisciti 

(posterior  layer)  of  hat  k  \  posterior  layer) 

-Transverse  .sectiim  of  the  |Hjstcrior  wall  of  the  abdomen  in  the  lumbar  region  isi  hematic ). 


according  to  ihtir  shajie,  in  three  subdivisions— the  flat  or  surface  muscles,  the  long  muscles,  and 
the  short  muscles.     The  flat  mu.scles  are  still  further  subdivisible  into  several  la  vers,  some  of 


'n     ' 


Semispinalis  capitis  -, 
Splenitis  capitis 


Occipitalis 

-  Sternocleidomostoideiis 
-Levator  scapulae 


-  Sacrospinalis 


^li~Obliquus  abdominis  cxteniin 


Lumbar  triangle 


■   \\\ 


Fig  236 


■'  i 


1      s 

;■■   f 

<      E 

!        ! 
; 

IH: 


mmstsU 


THE   MUSCLES   OF  THE   BACK. 


145 


which  completely  conceal  the  others;  the  superior  layers  are  inserted  into  the  skeleton  of  the  upper 
extremity  ami  conse(|uently  are  really  muscles  of  the  extremity.  The  lonj;  ami  short  muscles  are 
jjortions  of  the  actual  musculature  of  the  trunk,  and  are  situated  in  the  guww  l)et\veen  the 
spinous  j)rocesses  of  the  vertebra,-  and  the  angles  of  the  ribs  (or  the  costal  processes  of  the 
remaining  vertebne),  and  many  of  them  extend  u])\var(l  as  far  as  the  hea'l.  The  long  muscles 
of  the  back  extend  over  a  large  number  of  vertebrx-  'ml  in  tluir  su])e  lal  layers  extend  over 
the  entire  vertebral  column;  the  short  muscles  ])ass  from  vertebra  to  vertebra. 

The  flat  muscles  are  also  designated  as  superficial,  the  long  and  short  as  deej)  muscles  of  the 
back. 

THE  FLAT  MUSCLES  OF  THE  BACX. 

The  flat  muscles  of  the  back  (Figs.  2,^6  and  238)  are  arranged  in  three  layers  which  partially 
over'ap  each  other.  The  first  layer  i>  Id -med  l)y  the  trapezius  and  the  latissimus  dorsi,  the  seccmd 
by  the  rhomboidei  and  the  levator  scapulx,  and  the  third  tjy  the  serratus  |)osterior  superior  and 
inferior  and  the  sjjlenius  capitis  and  cervicis.  The  muscles  of  the  first  and  second  layers  are 
inserted  into  the  skeleton  of  the  extremities;  those  of  the  third  layer  find  their  insertions  in  the 
skeleton  of  the  trunk. 

The  First  Layer. 

The  trapezius  or  cucullaris  (Figs.  2,;f)  and  256)  takes  its  name  from  the  trapezium  formed 
by  the  muscles  of  the  two  sides.  Each  muscle  by  itself  is  triangular,  its  longest  lH)r(ler  i)eing 
situatc-d  at  the  vertebral  column.  It  is  flat  and  sm(X)th;  below,  ami  i)articularly  alx)ve,  it  is  very 
thin,  and  it  is  situated  in  the  nuchal,  median  dorsid,  sujirascapular,  scapular,  and  inlrascapular 
regions.  It  takes  origin  from  the  following  situations:  from  the  inner  half  of  the  superior  nut  lial 
line  (extending  to  the  linea  supn  na  as  a  short  thin  tendon),  from  the  external  (M-cijiital  protuber- 
ance, from  the  nuchal  ligament  (by  a  muscular  origin,  sometimes  by  a  short  tendon  i.i  the  upper 
jKirtion),  and  from  the  s])inous  i)rocesses  and  su])raspinous  ligaments  of  all  of  the  thonuic  vertebne 
(more  or  less  tendinous^. 

It  is  inserted  into  the  i.,.p-  '>f  the  acnmiial  third  of  the  clavicle,  into  the  iniur  margin 

of  the  acromion,  an<l  into  the  jnglli  of  its  upper  border,  and  jiartly  aJM)  into  the  inner 

portion  of  the  lower  border  of  ti..    jiine  of  the  scapula. 

The  superior  fibers  of  the  trapezius  pass  from  within  outwani  and  from  above  abruptlv 
downward  to  the  lateral  portion  cf  the  neck  (Fig.  250);  t'' ■  middle  fibers  are  tiie  shortesi  and  p:is> 
almost  horizontally  outwani;  while  the  inferior  fibers  r,  from  within  outward  and  from  b.-|ow 
al'ruptiv  upward.  Tendinous  areas  are  constantly  found  at  the  origin  of  tiie  trapezius  from  the 
occiput,  in  the  region  of  the  seventh  ciTvieal  vertebra  ami  of  the  spines  of  the  upper  thoraeu 
vertebra',  and  at  its  insertion  into  the  inner  end  of  the  spine  of  the  seainila  ;  the  fil)ers  coming  from 
the  S])ines  of  the  lower  thoracic  vertebra'  arc  alM)  tendinous  for  a  certain  dis*  .nci ,  and  in  the 
region  of  the  spines  of  lite  upjier  thoracic  vertebne  tiie  museles  of  the  two  sides  form  a  broad, 
well-developed,  trapezoid  aponi'urosis. 

.\t  the  occiput  the  trapezius  joins  the  tendinous  insertion  of  the  -ternoc '  '.  lomastoid.  He 
tween  the  two  muscles,  the  s])lenius  capitis  and  the  levator  scapula-  are  always  iiarllv  \  isijjle,  and 
if  tile  ui)per  part  of  the  tra])ezius  is  narrow,  a  jiortion  of  tiie  seinispinalis  capitis  al-o  ajijiears 


li 


I 

1 


i ' 


145 


ATLAS    AND   TEXT-BOOK    OF   HUMAN    ANATOMY. 


between  it  and  the  splcnius  capitis.  The  deltoid  has  its  origin  immediately  adjacent  to  the 
insertion  01  the  trapezius,  and  a  small  transverse  muscle  occasionally  passes  between  the  insertions 
of  the  trapezius  and  the  sternocleidomastoid;  it  is  known  as  the  transirrsus  nucha-  {Vig.  244), 
and  usually  has  a  tendinous  origin  from  the  tendon  of  one  muscle  and  passes  to  ihc  vcndon  of  the 
other. 

The  trapezius  is  supplieil  hy  the  .icccssory  none  an<l  by  the  ccnnr.il  plexus. 

(Jn  aetount  of  the  dilTerent  directions  taken  by  the  fibers  in  different  ixirtions  of  the  trapezius  the  function  of 
the  musi  e  is  complicaled,  and  differs  ac  ording  to  whether  all  portions  of  the  muscle  contract  simultaneously  or  individ- 
ual ix)i  ...ir.s  contract  separately.  Its  action  .dso  de()cnds  upon  whether  the  scapula  is  fixed  or  movable.  The  upper 
jiortion  of  the  tra|K'zius  elevates  the  entire  sli  ider  girdle,  the  lower  portion  pulls  the  scapula  downward,  and  the  middle 
portion  ilr:ius  the  .scapula  backward  toward  the  vertebral  column.  The  sca|>ula  is  also  drawn  backward  by  the  ,iciion 
of  the  entire  muscle,  since  the  upper  and  lower  fasciculi  neutralize  each  other  to  a  certain  extent  and  aid  the  middle 
portion  of  the  muscle.  If  the  shoulder-blade  is  fixed,  the  muscle  turns  the  head;  when  both  scapulx  are  fixed  anil 
the  two  muscles  act  together,  the  head  is  extended.  The  muscle  may  also  fix  the  scapula.  It  usually  acts  together  with 
the  levator  scapuli,  the  rhomboidei,  the  splenii,  and  the  other  muscles  of  the  l)ack. 


!■ 


=   !•■» 


The  latissimus  dorsi  (Figs.  236,  238,  269,  and  272)  is  a  broad,  thin,  triangular  muscle  which 
becomes  somewhat  thicker  toward  its  insertion.  The  upjur  y)ortion  of  its  oriirin  is  1  rtlv  con- 
cealed by  the  tra])e/.ius,  and  it  is  situated  in  the  median  dorsal,  the  sacral,  the  lumbal  he  infra 
scapular,  and  the  scapular  regions.  Its  origin  is  tendinous  throughout,  with  the  exception  of 
three  or  four  accessory  digilalions  which  arise  from  the  three  or  four  lower  ribs.  The  tendon  of 
origin  is  furnished  by  the  jrasterior  surface  of  the  posterior  layer  of  the  lumbodorsal  fascia  (see 
jiage  156),  by  means  of  which  the  muscle  arises  from  the  s])inous  jjrocesses  of  the  lower  li\e  or 
six  thoracic  vertelira',  from  the  s])inous  jirocesses  of  the  lumbar  \iTtel)ra',  and  from  the  median 
ridge  of  the  sacrum  and  the  neighboring  jjortion  of  the  outer  lip  of  the  crest  of  the  ilium.  The 
superior  fil)ers  nm  almost  horizontally;  the  inferior  fibers  ascend  abruptly  from  within  outward 
and  from  Ijelow  upward,  and  toward  the  insertion  the  fibers  converge,  and  terminate  in  a  tiat 
tendon  which  is  adherent  to  that  of  the  teres  major  and  is  inserted  with  it  into  the  lesser  tubercular 
ridge  (the  posterior  lip  of  the  bicipital  groove)  of  the  humerus.  .\n  almost  constant  bursa,  the 
lalissimus  bursa,  separate-  the  non  adherent  ])ortions  of  the  tendons  of  the  latissimus  dorsi  anri 
teres  major. 

The  tendinous  surface  of  the  ])osterior  layer  of  the  lumbodorsal  jascia  (Figs.  2,v'*  and  240) 
is  widest  in  the  region  of  the  middle  and  lower  lumbar  vertebra",  and  it  becomes  markedly  nar- 
rower as  it  extends  upward,  and  to  a  lesser  degree  as  it  ])asses  downward.  Between  the  U])j)er 
border  of  the  latissimus,  the  lower  br  rder  of  the  tra])ezius,  and  the  vertebral  border  of  the  sca])ula, 
there  is  a  triangular  space,  which  is  larger  or  smaller  according  to  the  ])osition  of  the  scapula  and 
in  which  are  visible  a  ])ortion  of  the  rhomboideus  major,  small  ])ortions  of  one  or  more  of  the 
middle  ribs  with  their  intercostal  muscles,  and  a  segment  oi  the  iliocoslalis  dorsi.  Upon  the 
neighlxiring  dorsal  surface  of  the  scaj)ula,  the  dense  infraspinatus  fascia  covers  the  infraspinatus 
muscle,  and  a  portion  of  the  deltoid  muscle,  covered  by  its  fascia,  is  also  \isibU'  in  this  situation. 

The  costal  serrations  of  the  lalissimus  dorsi  interdigitate  with  the  inferior  serrations  of  the 
oblif|UUS  abdominis  externus  (Fig.  247).  Retween  the  outer  Ixirder  of  the  latissimus,  the  pos- 
terio"  border  of  the  external  oblique,  and  the  crest  cf  the  ilium  there  is  usually  a  sm^'U  triangle. 


TITF.   \rUSCLF.S   OF   THE   BACK. 


Is. 


the  lumbar  triangle  or  triangle  oj  Petit  (Fig.  236),  in  which  a  portion  of  the  orij^in  of  ilic 
abdominis  intemus  from  the  anterior  layer  of  the  luml)ar  fascia  (see  i)am'  i()o)  is  exju-'sed       The 
posterior  border  of  the  latissimus  dorsi  forms  a  part  of  the  posterior  bounchiry  of  the  axillary 
jossa,  and  the  muscle  not  infrequently  receives  accessor)-  fibers  from  the  interior  anj^le  of  the 
scapula  (the  scapular  digitation). 

Since  the  latissimus  is  rially  one  <>f    he  muscirs  iif  the  e\trvn,ily,  it  is  sup|ilieil  from  the  plexus  liraihialis,  its  nerve 
Ix'ir.R  the  thur.ieodnrsal  (middle  or  lonR  suhMapular)  nerve. 

The  latissimus  dorsi  adducts  the  arm,  carrying  it  backward  and  rotating  it  inward. 


::;! 


The  St:concI  Layer. 

The  second  layer  of  the  flat  must  ks  of  the  '  -ick  ( Fig.  2i,S)  is  coveretl  by  the  trai)e/,ius,  with 
the  exception  of  a  j)ortion  of  the  rhomix>idea.  major,  which  is  exj>osed  Ix'tween  the  latissimus 
and  the  trapezius,  and  of  that  pan  of  the  levator  scapuhe  which  is  situated  immediately  beneath 
the  cervical  fascia  at  the  outer  lx)rder  of  ;lie  trajie/.ius.  This  la\er  is  not  '•(.■i)resente(i  beneath 
the  latissimus  which  directly  overlies  the  third  layer. 

The  rhomboideus  major  (Fig  2.:;8)  is  a  flat  and  rather  thin  (|ua(lrangular  iiui.scle  which 
arises  from  the  spinous  pcoces.ses  and  supras])inous  ligaments  of  the  upper  four  llioracic  \ertebra'. 
Its  fibers  are  distinctly  ])arallel  and  pass  downwird  to  be  inserteii  'nto  the  \ertebral  Ixirder  of  the 
scapula  Ix'low  the  r(K)t  of  the  sjjine.  The  muscle  is  freipiently  rather  intimately  coniu-cled  wiili 
the  rhomlioideus  minor,  and,  according  to  the  jjosition  of  tlie  sca]iula,  may  Ije  eitlier  (|iia(hanguiar 
or  rhomlx)i(lal  in  sliape. 

The  rhomboideus  minor  (Fig.  2,vS)  resembles  the  majnr  in  e\-er\'  n^jied,  l)iii  i>  nnu  h 
narrower.  It  takes  origin  from  tlie  spinous  ]ir()cesses  of  tiie  two  lowirmost  cer\i<al  \ertel)ra' 
and  inserts  into  the  vi  rtei)ral  margin  of  the  sca])ula  above  the  root  of  the  .spine.  Tiie  two  rhom- 
boidi'i  are  separated  by  a  cleft,  which  is  usually  (|uile  narrow,  and  as  a  rule  their  origins  are 
distinctly  tendinous  (ajjoneurotic). 


The  rhoml)oi<lei  are  supplied  from  the  brachial  ple.xus  by  the  dorsal  ^-lapular  nerve 
toward  the  vertebral  column  and  somewhat  upward. 


'I-hcy  draw  the  s,  apula 


The  levator  scapulae  (Figs.  2^58  and  25S)  is  the  only  one  of  the  flat  mu.scles  which  possesses 
any  considerable  degree  of  thickness.  Jl  is  an  elongated  muse  K-  wiiicii  arises  by  four  short 
tendinous  digitations  from  the  posterior  tubercles  of  tlie  transxtrse  pro(  t-.s.sis  of  tiie  four  upper 
cervical  vertebue,  tlie  largest  digitation  coming  from  tiie  ir-ins\ir.se  ]iroiess  of  the  atlas.  Tiie 
digitations  unite  to  form  a  single  belly  wliicli  ])asses  outward  and  downward  and  is  in.serled  into 
the  sui)erior  angle  of  the  scapula  immediati'ly  alongside  of  the  riiomboideus  minor. 

The  levator  scapuhe  forms  a  portion  of  the  lateral  cervical  regitm  and  is  immediately  ailjacent 
to  the  ])osterior  margin  of  the  .scalenus  ])osterior.  Its  origin  is  partly  covered  by  the  posterior 
portion  uf  the  stenioclcitlomasioid. 

The  levator  scaimhe.  like  the  rhomlxiidei,  is  supplied  by  the  dors.il  scapular  nervi .  It  elevate-,  the  supirior  angle  ..f 
the  scapul.i  .ind  <on.se(|uently  the  entire  shoulder-blade,  thereby  assisting  the  trapezius  and  the  rhomlK)idei.  When 
the  scapula  is  fixed,  it  can  incline  and  rotate  the  cervical  [mrlion  of  the  vertebral  column. 


^I^i^^:^^^^t,^:;ii 


^^fp- 


y 


148 


ATLAS   AND    TEXT-BOOK    OF    HUMAN'    ANATOMY. 


i 


Fig   ,,8— The  deeper  lavers  of  the  flat  muscles  of  the  back. 

'  "  ,  ,     ■     ■  1      '  1  ,  „  ,  ,,t  .m-iv  on  the  rieht  siik'  thr  rhom))oiiU'i  have  also  been 

si-rratus  posU-ricir  inl.Tior  anil  tii'low. 


The  Third  Layer. 

The  muscles  of  this  laver  (Figs.  238  an.l  239)  are  situate.l  partly  beneath  the  rhomboidei  and 
panlv  dircctlv  beneath  the  iatissimus  ami  die  trapezius.  The  two  splenii  are  also  covered  at  the.r 
origins  bv  a  muscle  of  the  same  lax  er,  the  serratus  iH^stenor  superior. 

The  serratus  posterior  superior  (Fig.  238)  is  a  flat  muscle,  rhomlK„dal  ,n  shape  whch 
is  tendinous  for  alntost  half  its  breadth  and  is  wholly  or  almost  wholly  covered  by  the  rhomlx^K  e.. 
1,  arise^  bx  an  aponeurosis  from  the  spinous  j.rocesses  of  the  two  lowermost  cerv.ca  and  of  he 
uvo  uppermost  thoracic  vertebra-,  passes  outwanl  and  downward,  and  is  mserted  by  four  Hat 
muscular  .limitations  into  the  outer  si.le  of  the  angles  of  the  secon.l  to  the  l.llh  ribs. 

„  i,  suppli..!  by  ,h|.  u,,p>.r  nirs,  „.  fnunln  inu-.,.tal  nerve.  U  draw.  ,he  upper  ribs  upwanl  an,l  ba,  kwar.l  an,l 
aii>  ..^  a  niusile  iif  inspiraliun  In  enlarniiiK  ihe  \h  .rax. 

The  serra.us  posterior  inferior  .Fig.  238)  resembles  the  serratus  posterior  superior  in 
nruix  respects,  but  it  i.  llatler  an,l  its  libers  run  from  within  outwar.l  and  from  below  upward 
1,'arise.  from  the  anterior  surface  of  Hk-  posterior  layer  of  the  lumlx.lorsal  fascia  ,n  common  wuh 
the  im^.imus  do.M,  at  lite  level  of  the  two  lowermoM  thonu  ic  and  tile  two  uppermost  lumbar 
vertebra  ■  it  is  at  first  a  thin  and  in.Kpendent  aponeuroM.,  but  subse,|uenlly  be.  omes  entirely 
musctda,",  ..n.l  is  inserte.1  into  the  lower  b..nlers  ..f  the  lower  f..ur  ribs  by  .ligitations  whuh  fre- 
.|U.'ni!v  \;;rv  in  ih.ir  .Uv.lopmcnt  or  may  be  wanting. 

.nu.  nu,.  1.    ,-  ^applie,!  bv  ,he  1 r  ,nln,h  ,.,  nvelfh,  in,er„.>al  nerve.     I.  Mraw.  .be  inwer  rib.  ba.  kwar-l  and 

,,„„,.!,;:,     \Jher  !,„„b  in,.K„n.n  .„   expirau,.  ,.,  un>.r,ain,     in  eiU.er  ease  i,s  .nlluen,  e  u,.,„  .be  r.l.>  ,s  .er> 
vli^ht       H  may  in.  rease  lb,   iei.-.i..n  ..|  ih,    lun.bar  l.i- i  i 

■lb.-  splenius  capitis  -  F,u.  .3S  ami  230^  i^  a  strong,  elongat..!,  stra,.  sh:.pe,l  mus,  !.■.  uliich 
,riM..  Us  nu  an.  .,f  the  nu.  h.,1  iiganun,  lr..m  th..  spinous  ,.,... sses  of  tit..  low.T  four  or  t.v..  cervual 
„„|„.„nnl,.upp.r.w.,onh,v..,hora,iev.rt,b,.e.  I,  pa.^ses  from  within  oulwani  ami  from  below 
,,„,,„,  -  ,nlv  ...vere.l  In  th.  trap,  /ni.,  du'  rh,..nbnidei,  ami  ttu-  ^.  rrattt.  posLTtor  sup.ru.r,  ami 
ll  i,,:,  ,  ,  i.'  intn  tiie  .,ute,  halt  ol  ,l,e  upp.nm.st  nuchal  line  n|  tin-  occipital  b-wu^  .M.'mbng  a> 
(..,•  ,.  lb.   nu-tuid  pro.  e...     Tlu'  ins.-rlion  i.  .ov.tvd  bv  the  stermH  le.,ln,m.sl.nd. 

The  splenius  cervicis  (Fig.  2m>^  i~  MU.ai.d  unmcliatelv  to  th.  nut..-  sul.  ..I  tin-  spleniu> 
...,„i,,.  It  ,ui-..inimmediat.M,c...M,.n  m  ilu^  i.ittrr  nuis.  le  fn-m  th.-  spimn,.  pn.cess..s  ot  tlu^ 
,;J,.,,  .;,.  f„„„|,  ,„  ,„.■  Itfth  or  sivth  thora,  i.  v.„.  b.a-,  ami  ,.asses  ..bli.pi.  Iv  outward  ami  upwanl 
.,.3  11,.!  but  rath..-  sl.n,ler  mu>.l.,  .0  b.-  in.n.d  into  the  poM.rior  tub.n  K  .  ol  th.-  transverse 
,„-,He-M->  ..f  du  upper  tuo  or  ihr.-c  ..-ni.al  v.  rt.bra-.  It^  in.-rtlo,,  i.  intimal.ly  conne.  t.d  w„h 
tl-,(-  ,,riuin  of  lib-  1.  \ator  Mapuhe. 


-,b,    ,un   .pl.nu  .,r,    -upph..l  f .he  p„-b-r,„,  ,l.u-i..n,  ,.f  ,h.  ^..-,..m,I  .,..1..    .i«l.ll'_^ 

uiv.li-.  •,(  l'..lll  -i,l,       1,1    in  ,,.nnii,in.   It"-v    pni'  li"    '"-"i '"    ■ "  ■ '^  •   ''■^■'^~  ■■■■'■    ■'■■ 

„,   ,|„„..,   ,b.:    lun,  .lu    b.,„ 1 k'  - ir'l  ""    ■"'•    "f  ""    ""-"■"•"'«  '""-" 


•  i,  .il  M,-rv,.-       Wlu  n  111, 
1       ...,,v.  |.  5   ..f   .ini-    >iil|. 


ii^iS?-*'*^-. 


Oiri/iitalis 
Simis/iirialis  capitis 


Sternorleidomastoidfus 


(Supraspinatusj 


Teres  major 


I  ntissimiis 


Serratiis  anterior - 


I  iiitssimm  * 


Obliquiis 
aMominis  internus 


^       / 


Hi 


/li'.   JiS. 


^ 

«j' 


THK   MIISCLKS  OF   THE   BACK. 


149 


THE  LONG  .MUSCLES  OF  THE  BACK. 

The  long  muscles  of  the  back  (Figs.  23Q  and  242)  arc  sulxlividc.l  int..  two  layers  accordinK 
'o  the  direction  of  ihcir  fasciculi.  In  the  superficial  layer,  the  spinolransvcrsalis,  the  hl.ers  j.ass 
from  the  spinous  processes  to  liie  transverse  processes  or  to  the  ril.s;  in  the  dee])  layer,  th.-  Innis- 
irrsospiiialis,  the\-  jKtss  from  the  transverse  to  the  spinous  proces.es.  The  sftnuilis.  heloni^- 
ing  to  the  upi)er  hiyer,  is  the  only  muscle  j.assing  from  spinous  ,u-ocess  m  spinous  pnuAss. 

The  First  Layer.     The  Spinotransversalis  and  Spinalis. 

The  muscles  of  this  laver  (Fig.  2,?<)l  fill  the  vertebral  groove  between  the  spinous  processes  of 
the  verlebrx  and  the  angles  of  the  ribs,  and  extend  over  a  large  area  of  the  vertebral  column, 
usuallv  the  entire  length  (,f  the  back.     With  the  exccpti.m  of  a  Miiall  i.ortion  xvliiili  may  heduectly 
beneath  the  >kin,  between  tiie  trapezius  an-t  the  latissimus  dor-i  (see  page  145'.  'h^T  •''•c-  com- 
pletelv  covered  either  by  the  Hat  muscles  (,:      .■  I<ack  or  liv  the  poMrrior  layer  ..f  the  lumbar  fa>c.a. 
The  spim.transverse  fibers  form  a  .ingle,  large,  (..mpli.ated  nui-cle.  llie  s,t,  ros piiuili^. 

The  sacrospinalis  or  nr,l„r  spimr  iFigs.  2,V)  and  241  1  i-  a  l'>ng  and  Mrong  muMiilar  ma-s 
wliich  extends  from  the  .lorsal  -urfa.e  of  the  sacrum  and  the  en -t  of  the  ilium  t.,  the  ^kuii.     il 
forms  a  .ingle  mas.  ontv  in  it^  louvr  portion.  dividLg  a.  it  i.a.sis  up\\,ird  into  t«o  -Maratr 
nvasdes,  thi"  external  and  weaker  i!ion>sl>ilis  and  the  internal  and  .trongir  lon-i.ssiwu.  <lorsi. 
Internal  to  the  latter  muscle  and  a<lherenl  to  it  is  .ituale.l  the  spinalis,  .0  tliat  the  .uperl'ii  ial 
layer  of  the  Ion-  mu.cles  of  the  back  is  arranged  in  three  longitudinal  strips  U]ion  1  iilu  r  .i.!e  of 
the  vertebral  ...lumn,  a  strong  median  one.  the  /,u/,,'/,v.;»n(  .,  an  eMrrnal  .mu  ,  du-  //;■,.M.^/.,//^,  and 
an  internal  one  the  spinalis.     Before  its  division  l\u-  .aero.pinali-  i^  a  ihid.  pourrful  nuH.ular 
ma-,  who..-  .urfaie  i.  sironglv  aponeurotic  and  which  ari.e.  fmni  the  .lorsal  .urfa.e  u\  \hv 
.a'erum,  fr..m  the  spinous  ;,ro.-e-.s  ..f  the  lumhar  v.Tlebra-.  an.l  In.m  ih.'  <  r.'M  ..1  ll'.    ilium  an.i  i. 
indu.leilbetwun  the  iw..  layers  of  tlu' lumbar  fascia  (seepage  i.*.,.     Tin-  ilin,.,Mali^  luinb..nnn 
an.l  the  lonui-imus  .lor.i  pass  iipwar.l  <!irectly  from  this  ma-.. 

Till' iliocostalis  I  Figs.  2,vjan.!  2|m  i,  tin- .mi.r  p..ninn  .it  tlu-a.  r.i.pinali-,  and  i.  ..>inp..-..l 
..f  three  sub.liv  i-i.m-     the  //ww/...;^  liimborum.  .lor^i,  an  I  .inids. 

Tlu'  ilionnlatis  Inmhanim  (Figs.  j,;o  and  241  '  ari..  -  in  t.>mm..n  uiih  llu-  l.Migi-nnu-  an.l 
in-erl.  inn.  th.   an^d.-  .-I  llu-  lilth  L,  llu-  1    .■Iflh  ril^.     ■Hi,-  Mip.  rior  inMiliun-  an    I.',    m.an-  ..f 
1,,,,,^  irnd..n-,  xvhil.'  lb.'  l-'.ur  in-erti-n.  aiv  in  th.    .hape  ..f  ll.  ^Iin    m  rraliu,,-,  llu     |..-A.rnu.-l    ..! 
whi.  h  i-  the  .ir.mmM  .iml  pa.'c-  to  tlu-  l.iwer  bonier  ..f  llu  tw.lfili  rib. 

The  greater  p..niun  ..f  ihr  "vigin  ..I  ihe  ilio,  nshil,-,  ,!■'•■. i  .Fig-.  j,^.)  an.l  .mi     i-  .nv.iv.l  by 
,lu   ili......lali-lumb..n.m.      !la,i-.--lA  m.  an.  ..I  .p..  iai  ,    ..-^.-in  m  naii.m.  Imm  iIu  inn.  r -i.l.- 

„f  the  angles  ..i  the  tv-illih  t..  llu-  ..x.  nlh  lib^  and  i-  in->.  (L-  b-    thin.  I.n.ion-  xvhi.  Ii  pa.s  t..  llu- 
an-l.s  ..fllu-  siMh  1..  llu-  fii-M  ribs  and  I.,  llu  iraiiM.  r-.-  pn...  ss  ..1  llu-  la.i  ..  rv  i.  al  \.  ru  bra. 

"  The  iliiHO-'ali''-  "Wins  (Fig..  2,;o.  ^  \o,  and  .' 1 1  ;.  ab.,  1.  rm.  d  llu  nrii.ali^  .r. ,  n.A  i;>,  h  a 
.K-n.ler  mu..i.-  llu-  ..riuiu  ..f  ^^Wwh  i-  imimaU-K  ...niucU-.l  uiih  ilu  ili.M.Mali-.  .I.'!-!,  ll  ...nu-- 
In.m  the  upper  .nul  mid.lle  rib.  in  a  variabi.-  mann.  r  ,,n-i  b  i.-.  lU-d  b>  n.irn.u  I.  u.lnn.  inin  ihe 
n-an-v.-r.e  pn..e-^.c-  ol"  llu-  niid.il.-  . .  r\  i.  al  \, rubra  imm.  .'..H.-K  aL.ng.i.le  ..|  llu  ..  al.  nu.  po. 
U-rior  i.ee  pau'e  17V,  \\illi  ll"   "Hi-in  "I  «hi.h  il  ma;,   b.   .i.iiunnl. 


,  1 

1 


It  1 


i  \ 


150 


ATI.AS    AND    TEXT-BOOK    OF    in'MAN'    ANATOMY. 

Flc.  2^9.— Tlie  superficial  '-vcr  of  the  lonj;  musclo  of  the  back. 
All  Ihi'  flat  mus<:k-s,  thi-  spli-nii  and  the  iliiKOstalis  of  ihf  Irft  >i.li-  liavf  Win  removed. 


The  longissimus,  tlic  inner  ])()rti()n  of  ihc  sai.rosi)inali.s  is  comi)OhC(l  of  three  subdivisions 
-the  loiii^issiniK.'i  dorsi,  icn'icis,  .-.nd  capilis. 


K,il,ll,iris  liillgi 


littUtiin  >  .'•ii  L'(5 


Miiilifniiii 


•  Tr'i>'S7'rrst'  ftrinrsses 


Srni,\fn''!>lhs 


Kl...   j(o,-I)iairr,im  ..f  ihe  arrariRrment   .if    ilir  varum-,  portion-,  of  Ih.    iranr-VTr-o-piimlis  UeMU,..|nnali>.   nmll(liilu«. 

roialorr.*). 


The  l<iiii^:'.siniii\  dorsi  i  f-"it;s.  _>  ;(>  and  241  1,  in  addilion  to  its  common  origin  with  the  ilio- 

cosi.iii^  iuini)oruni.  riTei\e>  an  ■^^oi\  un^^iii-  li lin   ll".ili.s\  (  rsc  ]iroccsscs  01  nis-  tw.  ,;  ,;it'i.:'.  n 

vcrjf  r;i-.     Its  insertions  are  arranged  in  an  inlirnal  and  in  an  eMernal  series,  and  are  partly 


Splenius  capitis  x 

Longissimus  capitis  — 
Splenius  cervicis  x 
Longissimus  cervicis 


Nuchal  Ug. 

Splenius  capitis 

Sternocleidomastoid 

Splenius  cervicis 
Levator  scapulae 


lliocostalis  cervicis 


Semispinalis 
dorsi 


Obliquus  abdominis  ext. 


Serratus  poster. 

super  ■ 


Spinalis 
Latissimiis  ilorsi 


Serratus  iiiitifiot 


"^•Srmilus  poster,  infer 


I 


Nff.  230. 


CcS? 


!#[ 


-,?: 


■ 


if.-- 


THE  MUSCLES   OF   T     "   BACK. 


151 


fleshy,  partly  tendinous,  and  their  digitations  arc  frequently  yariable.  Those  of  the  internal 
series  are  inserted  into  the  accessory  processc-s  of  the  ui.l)er  luml.ar  yertebra-  and  into  the  trans- 
ycrse  processes  of  the  thoracic  yertebrie;  those  of  the  external  series  insert  into  tlie  apices  of  the 
transyerse  i^rocesses  (cistal  ,.rocesses)  <'f  the  upper  lumlxir  xerlebra-  and  int..  the  ribs  bet^veen 
the  angles  an<l  the  tubercles.  The  serrations  of  'he  internal  inserti.-ns  conse.|uently  pass  to  the 
transverse  processes  and  their  homoloRues,  while  those  of  the  c^xlernal  series  run  to  the  ribs  or 

homologous  narts. 

Tlie  lon^^issimus  crvkis  .Fi-.  2,;o,  241,  and  242).  also  known  as  the  tnwsvrrsahs  an'uis, 
is  the  direct  'continuation  of  the  lonKi»imus  <iorsi.  h  ari.e^  fn.m  the  transverse  i-meessesof  the 
upper  thoracic  vertebra-,  is  situated  immediately  internal  t..  the  ilioeostalis  cervu  ,s,  an,  ,>  inserted 
by  tendinous  slii.s  into  the  iransvei-e  processes  of  the  uj.p.r  and  n.id.lle  crvical  vertebra'. 
■  The  lo,r^issimus  a.pHis*  (Im^s.  2,,o,  241.  and  2^2)  i^  the  only  portion  ot  the  sa.rospmahs 
Nvhich  extends  uj)  to  the  head.  It  is  >itualed  internal  to  the  lon-issimus  cervicis.  with  the  on-in 
of  which  it  is  fre(iuentlv  unite.l,  and  arises  by  separate  short  ten.linous  slip>  ol  variable  .xlen. 
from  the  transverse  and  articular  processes  of  the  middle  and  lower  cervi.  al  Ncrtebra-  .,  ,d  trom 
the  transverse  processes  of  the  up|,er  thoracic  vertebra-.  Thi>  muscle  often  presc-nt>  a  i.udin.nis 
inscription,  i.  inscTted  bv  a  short  tetidon  into  the  posterior  margin  of  the  mastoid  pr.H.^s.  and  is 
comi.lelely  conceale.l  bx'  the  splenius  capitis.  The  iliocostalis  and  lon.L^issimus  cervun  :>nd  the 
lon^isvimus  cai.ili>  are  situated  beneath  (in  front  of)  the  two  splenii. 

■  The  spinalis  (Fius.  2^.,  an.l  241  )  i-  .omposed  of  the  splm.lis  .hrsi.  nrvias.  and  r„ />//;..  ol 
which  the  spinalis  <l..rd  alone  is  an  in.lepen.lent  and  constant  muMJ.-.  the  spinalis  c.  rvi,  w  b.ini; 
inconstant  and  the  sj.inalis  capiti>  a  part  of  ihr  semispinalis  caj.ilis. 

The  spinalis  dorsi  (Figs.  2V,  and  241.  is  intimat.lv  eonne.l.d  will,  the  t.nduuuis  .,n;.;m> 
„f  the  l.uv'i-inius  .loi>i  whi.h  ...m.-  tn-m  the  spin.uis  processes  ..f  the  lumbar  vrt.  1..  an.l  tak.'> 
its  ..ri.dn' partly  fn.m  these  b.mv  p..inls.  It  is  situate.l  al.-n-i.le  ..f  th.-  spine,  ot  du  ihora.u 
vertebra-  and  c.aUain>  i.am.n.us  ten.lin.ais  fas.  i.uli.  It  take,  it^  ..ri,.dn  trom  tl,.'  ^pm.n.s  ,,n.. 
i.sses  ..f  the  ui.per  lumbar  an.l  "f  the  lower  th.-racic  vertebra-  an.l  passo  I.,  the  sian.s  ..|  t h. 
mi.l.lle  an.l  upper  tii.M-acie  vertebra-,  bri.lging  over  one  or  two  ..f  the  spin.uis  ,,rocesse^  (Usually 
tin- ninth  .)r  the  .lintli  an.l  tenth). 

The  spinalis  nrviris  (Fig.  2  +  1)  i>  incnstant  ami,  when  i.rcsenl,  is  fre.|Uenlly  .|Uit.-  ru.li 
m.ntarv      It  is  a  verv  sUn.ler  muscl.   which  aris.-s  fn.m  the  spinous  i.ruoses  of  tin-  Mxth  an.l 
..venth  cervi.al  vertei.ra-  an.l  inserts  int..  the  spim.us  processes  .,f  th.'  .-pistn.pheus  (axisi  an.l  ol 
the  thir.l  cervical  vertebra-. 

Xn  m.on...n.  nn..,ul,,r  f..  i,  uUh  uln.h  arises  fr.,m  ,h,-  spi.vm,  ,,n...-ss.-s  of  ,1„.  Inn.r .  .ni,  a!  l'"'' "IM-""--^, 

(,..■    llUgl-    i%2). 


m 


The  Second  Layer.     The  Transversospinalis. 

The  fibers  ..f   this  laver  (Figs.  2,,()  t..  242).  i)assing  from  the  transv.-rse  t..  the   spin..us 
p.rocesses.  rei-rcsent  in  their  arrangement  a  portion  of  the  original  trunk  musculatur.-  whidi  has 

.Tlu>  mu,>l.-  lias  alsu  1h-,-„  U-rm.-.i  ih.  rr„„..,Tw/»  .apilis.  •>,.-  „.»,;,/.  v.,,  .„nor.  a,M  ,1,.-  ,r.„ l.r!..,„.nl«iJ 


3 

W^"* 

^     } 

i 

J 
) 

:  ^        1 

1 

;-t  !  » 

■it 
if/ 


^i'^^ 


15-^ 


ATLAS    AND   TEXT-BOOK    OF    HUMAN    ANATOMY. 


Tic.   241. — The  deeper  layers  of  the  loni^  mus'-les  of  the  back. 

On  llie  left  Side  the  sacrospinalis  has  iK'i-n  partly  removed  and  the  semispinaiis  has  been  cut  and  reflected. 
Flc.  242.— The  cervical  portion  of  the  deeper  lu.vers  of  the  muscles  of  the  hack,  .seen  from  the  side. 

Tlic  trapezius  and  splenii  have  been  r<move<i. 


un(li>rt;(ine  but  sli<,'ht  changes.  They  are  arranged  in  three  layers,  each  of  which  is  described  as 
a  special  muscle,  although  they  are  not  separated  by  fascia-,  but  are  distinguishable  from  each 
other  chieflv  b\  the  length  of  their  fasciculi.  The  semispinaiis,  the  most  superficial  layer,  has  the 
longest  and  conseiiuentlv  the  most  slanting  fibers,  which  bridge  over  from  four  to  si.\  s])inous 
]»roces.ses;  the  mullifulus,  tiie  middle  layer,  has  fa.sciculi  which  pass  over  two  or  three  vertel)ral 
s])ines;  and  the  rolatorcs,  forming  the  dec])csl  la\er,  either  extend  o\er  only  one  spinous  process 
(ro/dlon-s  loiii^i)  or  j)ass  to  the  next  succeeding  \ertel)ra  {rotalnrcs  hrrvi).  With  the  exception  of 
ihe  semispinaiis  capitis,  ail  of  tlie  fil)ers  of  the  transversospinalis  end  at  the  spinous  process  of  the 
axis.  The  semispinaiis  is  absent  in  the  lumbar  region,  and  the  rotatores  are  situated  chielly  in 
the  thoracic  region. 

The  semispinaiis  (Figs.  ^Vd  ^41-  and  242)  consists  of  the  snnispiiuilis  dorsi,  semispinaiis 
irn-i<is,  and  scmispiiuilis  capitis. 

'I'he  srmispiiialis  dorsi  1  Figs.  2,^()  and  241)  and  icrvicis  (Fig.  241)  are  direcily  continuous 
without  dc^marcalioii,  ihe  lowermosl  fibers  arising  from  the  transxerse  processes  of  the  lower 
tlioratic  'erteljnr,  and  the  upperni.)st  fascicidi  terminating  at  the  s])inous  ])rocess  of  the  axis. 
The  muscle  is  stronger  and  moP'  lleshy  in  the  neck  than  it  is  in  the  back.  The  fibers  of  the 
semisjjinali-  <iorsi  are  intermingled  with  numerous  tendinous  fasciculi  and  are  also  jjartly  con- 
neited  with  the  spinalis  dorsi.  The  muscle  is  completely  covered  by  the  longissimus  dorsi  and 
the  >emi>pinalis  capitis. 

The  .••'  mispiiialis  iiipilis  i  Figs.  2,;(),  241 ,  and  2421  is  a  llat  but  rather  thick  muscle  and  is  tlie 
slnumest  must  le  ni  the  neck.  .\-  a  rule,  it  consists  of  two  |iorlions  which  are  se]iarated  below  but 
adherent  abo\e  ai  iheir  in-t  rn'on  a  slnmger  external  or  .'•emis;)inal  i)ortion  and  a  weaker  internal 
or  spinal  ]iorli"ii.  The  -emi^pinal  segment,  sometimes  termed  the  fcm/J/cv;*.?, arises  by  numerous 
short  tendinous  --lips  from  the  transverse  jirocessesof  the  third  cervical  to  the  fifth  or  sixth  thoracic 
\trtebra',  whilt  the  s])inal  segment  arises  from  the  spinous  ])ro(  esses  of  the  lower  cerxical  and  of 
the  ui>per  iliorai  ic  vertebra-  (lite  spinalis  capitis  -.  This  latter  portion  is  characterized  by  a  tendin- 
i)us  inscriptimi.  ami  hence  is  >umetimes  termed  the  Idvcntir  tcrvitis,  aiitl  sometii..es,  when  the 
spinalis  lapilis  ;-  ab-.eni,  its  origin  extends  to  the  transverse  processes  of  the  second  to  the  sixth 
ier\ical  \'enebv,i .  The  external  portion  of  th"  muscle  also  usually  jiossesses  a  broad  tendinous 
in^iriptini  wIikIi  i-  situated  ab(i\e  tile  middle  trndim  of  ;he  liiventer.  Both  portions  ol  the 
musile  unite  and  pass  to  the  nucha!  surfai c  of  the  oci  ipital  bone,  where  they  insert  between  the 
siiperioi  .iinl  inferior  nuch.il  liius. 

The  multifidus  ■  Fig>.  J41  and  242!  consists  of  the  miillijidiis  lnml>onim,  dorsi,  and  (cniiis, 
but  tlicM-  ^egmenl>  (.iniiot  be  clearly  (lemartated  from  each  other.  It  commences  below  at  the 
:io-.!t'rior  -iurface  of  tb.e  .-aerutn  and.  ii/rniitiiiles  .;dio\r  .'it  the  siiinous  iirocess  ot  the  eiiistrophelis 
laxisi.  It  i-  >trongt>t  in  the  lumliar  region,  where  it  lies  direitl\  beneath  the  longissimu-^;  it  is 
weakest  in  llif  thoracic  region,  where  it  i<  cuxcred  by  the  semi>pinali-.  dorsi;   and  in  the  cervical 


Ttansversus  itnrhac 

Spknitis  aipi'is 


Splenias  capitis  x 


Splenius  rervicL 
-cngisiimus  capitis 

L'ngir.'imus  cervicis 
lUocostalis  cen'ids 

Semispinalis  dorsi 
et  rervicis 


Sicr-iocU-ido- 
maitoid 
SiHrmiif  cirvicis  ^ 


ilioro;.  talis  cenicis 


[■if:.   2tl. 


'i^xt 


i 


'    I 


THE   MUSCLKS   OF   TH  .   BACK. 


153 


region  i.  is  partly  concealed  bv  the  semispinalis  cervicis,  to  the  outer  si.le  of  which  it  i^  cu\  ere,l  hy 
lue  semispinalis'capitis.  In  the  lumbar  region  the  greater  portion  of  its  libers  arise  from  the  a. ces- 
sorv  and  mammillarv  processes,  in  the  thoracic  region  from  the  transverse  processes,  and  m  the 
cervical  region  from  the  articular  ],rocesses  of  the  four  lower  cervical  vertebne.  The  fasciculi 
are  interm'ixe.l  with  tendinous  libers  an<l  generally  extend  over  two  or  three  vert.'bra',  combining 


Occil>itii!  bone  (misi!i:r  firrlian) 

Alias 

Epistropbeui 


Jn!crtrnvsv<rSitrti  anuriorts 


J  lilt  nruiisi-frsdrii  N'!;trri"res  • 


l:.\Uriial  ociijihal  l-niliihi-r.iiio 


Xiuiiiil  ih^aminl 


IntfTipiiitdes 


y  lull  il  li^diunit 


-S/'inol.'i  tiriirr^^  n,'  nrvUill 
'.'•'.'■'lira  VII 

I'lC.   .-4  ,.— Diagr.im  of  Ihi-  nrviral  iin(Ts,.inal,-;  ami  intirtr,ui-v,r<arii  an.l  of  ihr  tin.  hal  Ht-aMunt. 

t-'  "orm  a  single  uninlrrru]ited  muscular  layer,  the  deeper  portion  of  wiiidi  i>  di-'.ingui<hable 
onlv  xvilh  dilVi,  ulty  from  the  rotalores,  i.arl  of  v.hose  libera  Mas-  ir,  th-  -:mie  dina  lion  ■:  Fi;.r.  .^)oi. 

The  •^Otatores  are  .oiiiiiosed  of  tlie  rol,ilor,s  loii-i  and  hn'r-i.  Thev  are  Muail,  llal,  and 
parllv  tendinous  muscles  which  lie  immediately  upon  the  vertebral  an  he>  throu-hout^  the  entire 
-,!,!!vd  rolumn.  h'.'.t  :ire  ehiellv  dewloiied  in  the  thoraiic  feL'ion.  The  rohUons  hnvfs  (Fig.  ?  |oi  are 
almost  horizontal  and  j.ass  from  the  transverse  i^rocess  of  one  vertebra  to  tlie  root  of  the  -pinou- 
procos  of  tlie  vertebra  next  above;   tiie  roluUms  loiti^i  (Fig.  240)  extend  over  one  or  ^(.metimes 


;!^; 


^xM'^^'MW'^W 


■^'' 


1 54 


ATLAS    AND   TKXTBOOK    OF    HIMAX    ANATOMY. 


M1ii' 


«M 


two  vcrtcbrie  before   inserting  into  the  roots  of  the  s])inous   processes,  iheir  fibers  having  a 
course  parallel  to  that  of  the  multifidus. 

All  of  tin-  lonf"  muiiU'S  of  tho  l>,uk  :irc  supplii'il  l>y  the  posU-rior  illvisions  of  iln-  -ipin:!!  lUTvis  (nTvical,  Ihorack, 
lumbar,  and  sairal'. 

""he  niajorily  of  tin-  lonp  muscics  of  ihi-  h...  k  have  ilic  sami.'  funrtioiT^,  If  the  nnis(li<  of  llu-  twr)  si'K-s  ai  1  fojrithir. 
till  V  liolil  ihi'  trunk  utirif»ht.  extend  the  vertiliral  i  olumn  and  ihe  head,  and  liend  Ihr  head  and  vcrti-bral  column  bai  k- 
ward.  During  nnilaieral  aili<in  they  brnd  or  rotate  the  vertebral  i  olunin  toward  the  (  ontraeling  sidi-.  The  stronRi-.t 
action  upon  the  h<Mil  i^  ,\mu.1  b\  the  two  veinispina]i>  i.ipiii-;  «lirn  ihey  act  loKether,  they  |iull  the  head  backward, 
but  whin  thiy  act  sinf-iy  they  rot„'r  the  head  so  that  the  fan-  i-  <lrawn  to,.,;i  1  Ah  opp  v.-c  side,  „■  •;  •  onseijuently  in 
the  opjiosite  dire,  tioii  to  that  in  whiih  it  is  turned  by  the  splenius  capitis, 

THE  SHORT  MUSCLES  OF  THE  BACK. 

The  short  muscles  of  the  Ixk  k  are  divided  into  two  <;roui)s:  those  whieh  are  found  ihrou^'h- 
out  the  entire  llexible  vertebral  column  and  those  which  are  situated  between  the'  a.\is  and  the 


1  iilrrlril  ttsirrS'irii  tii  -/li  tii'S . 


Ir.terlrr.m^vcriirii  l.ilcr<lh-s 


I  iilrr^pinali     , 


I'ir..   2(4,— Diafjrant  of  I'r.e  luni'Mr  intcr>|,'in:di  s  and  inti-rtransversaril. 


atlas.  The  first  f;rouj)  is  rom])0.=ed  of  two  further  subdivisions:  the  inhrspiiuilcs,  bt.-tween  the 
spinous  proees,ses  of  the  vertebras  and  the  inlirlrausvirsarii,  between  the  trans\er>e  ])roces.ses. 
The  second  oroui)  is  also  desifjnated  as  the  short  muscles  of  the  neck. 

The  interspinales  !  Ki.ys.  241,  24,^  and  2441  are  -mall  mu.sdes  which  are  well  developed 
only  in  the  cervical  refj;ion  and  may  be  entirely  wantint;  throui^hout  the  thoracic  \(Ttel)rMl  column. 
They  are  connected  with  the  interspinous  lif^aments  and  jiass  from  the  spinous  jjrocess  of  one 


TITK   MT'SCI.I.S    OK   Till:    HACK. 


I^; 


vertebra  to  that  of  the  next  lower  one,  and  in  the  bifid  s])inous  proeesses  of  the  eerviral  vertebne 
they  form  paired  j-truetuns.  Like  the  majority  of  liie  museles  of  ihc  Ijaek,  liuy  do  not  im^,-.' 
beyond  the  s])inous  process  of  the  epistropheus  (axis). 

The  intertransversarii  (Im,i;s.  24,^  and  244)  are  small,  short,  |)aired  muscii's  whieh  eomurl 
the  transverse  processes  of  nei.uhborin.H  vertelira'.  Thiy  arr  doubk-  uiion  bolh  sidrs  and  are  well 
developed  both  in  the  eervical  and  in  the  lumbar  verlrliral  eoliimn.  Tluy  may  \ic  entirely  abst'nt 
from  die  thorai  i(  column. 

In  the  cer\ical  reijion  inlrrtriinsvrrsiirii  niilirinris  and  pn^lcrioris  1  l''ii_r.  2|,;i,  \\lii(h  run 
l>e!-.veen  ihe  anlcior  and  po.-tiTior  tubercles  of  du-  trans, crsc  proc  c  ssi -,  arc  dillcrenlialed. 
Both  muscles  are  .d)o,it  L.|uallv  developed:  the  anterior  ones  are  situated  in  the  anterior  cervical 
rather  than  in  the  luichal  reijion. 

The  intertransversarii  of  the  lumbar  rcL'ion  are  (onijioscd  of  the  wider  and   stronger  inhr 
trniisvirsiirii  lalcrulis.  runnini;  between  tin-  transverse  pronsses,  ,ind  the  narrower  and  weaker 
intertransversarii   medialcs,   whieh  extend    between    the    accessory   and    mammillary    processes 
(Fii;.  244I. 

A-  rl■l;,lrcl^  llirir  fumti'.n  ami  innrrvali'in,  tin-  imrr^i'i!..il.^  and  tlu  intrrlran,\irsarii  re-inililr  the  I"";'  niu>cle 
of  ihf  li.il  k. 

THE  SHORT  MUSCLES  OF  THE  NECK. 

The  short  muscles  of  the  neck  T''i,^-.  J  41  and  2y)\  arc'  the  reeliis  eafiilis  pif^Urior  majur.  the 
rcetiis  capitis  poslirior  minor, \\\v  rcc/n  ■  mpitis  iaiiralis.  \W  uhliiptiis  lapiiis  \ii  p<  rior.  mm\  tlie 
obliqiius  capitis  injeriar. 

The  rectus  capitis  posterior  major  Fii;.  2  in  arises  l,y  a  short  tin. Inn  fmni  iln  -pinous 
proeessof  the  axis,  runs  ujiward  and  outward,  becinninu'  muc  h  i)idader.  and  inserts  iiu"  the  middle 
]>c)rtion  of  the  inferior  nuchal  line  of  the  occijiital  bone. 

'"'he  rectus  capitis  posterior  minor  I'i;.^'.  2111  is  i<)nsideral)ly  weaker  than  ilu'  major. 
It  is  a  small  trian.^ular  muscle  wliiih  arise-  liy  a  shoit  Icaidon  from  tin-  iiosU-rior  tubercle  of  the 
atlas  to  the  inncT  side  of  and  partlv  bc-neatli  the  lectus  major.  It  runs  to  liu  inner  third  of  the 
interior  nuchal  line- of  the  occipital  bone. 

'I  ne  rectus  capitis  lateralis  ^  I-'ii,'.  251)1  arises  from  the  fansv.rse  proce>-  of  the  atke-  and 
inserts  into  the  jui;ular  process  o!  the'  occipital  bone.  It  rep.  -calls  the'  uppermosi  intertrans 
\ersarius. 

The  obliqUUS  capitis  superior  ii''i,Lr.  -l''  ^'bo  arises  from  ihc'  ir.illsverse  process  of  the 
atlas,  and  runs  to  the  outer  third  of  the  inl'erior  nuciial  line-  of  the  oiciiiiial  bone ,  where  its  |,  ndin- 
ous  insenion  jiarllv  covers  the  rectus  capitis  posterior  major. 

The  obliquus  capitis  inferior  1  Mi;.  241  1  is  a  rather  >,tronL;  ,d  lleshy  niusi  k  which  runs 
from  the  spinous  process  of  the  epistropheus  (axisi  to  the  Iran-  -e  process  ol  the  atlas.  It  is 
thick  in  the  n'iddle  and  becomes  narrower  toward  its  ori.Ljin  and  insertion. 

Till-  -hurl  iiui-i  ii-s  of  tiir  ni'i  k  an-  Mi|i|iiini  ii>   liu    |"i-.|,  n..i  ihvi-i..r.  ..T  ir..   lir-i  .i  rvi,  ,<:  nt  rvr  :  .■.;;■.•:  •  :;  ;:a:  nrrvr;. 

The  funiti.  ■-.  of  the  -linn  inu-.  Ir-  of  the  no  I,  pr.u  li.  allv  .nTi-i-,is  of  ,i  rotation  or  ,-\i,iisi.,n  ..,  ihr  hi  ail.  .lipi  ii.l.nt 
upon  whetlliT  thrv  ail  u|«in  ..nr  or  l„iil\  Mil,-,,  ■fhe  rr.  lei-  neiiior  .  an  onK  ,AI.-ral  ih.  li.  .i.l  aM.linv^  iiiov.  nu  nl  i ,  the 
rc-rliis  latiTali-  ini  line-  the  h,  ,i.!  lo  one  -i.lr.  ih.  olileiiiu-  iiif.-rior  and  tlu-  nuu-  major  roia;,  tin-  lioail  in  \\-'  -amr 
(lireition  and  are-  iippused  l)>  the  oliluiuu-  -upiri  or. 


W\ 


I 


156  ATLAS    AND    TF.XTHOOK    OF    HIMAX    ANATOMY. 

Fig   -'4S  --Suiicrfu-ial  and  second  lavcrs  of  the  abdominal  and  i)cctoral  muscles  seen  from  in  front. 
C^ii  thi'  rii;hl  tide  thu  pctonilis  major  ami  ihc  ..l.li.nuis  alKli.iiiinis  i-xUrnus  have  been  rcnic.v.-d. 


IVlw.-.n  llir  rr,tiK<a|.iiis  |.(,sl,Ti,>r  maj-r  an.l  llu-  ol,li,|.m.  .apiiis  suiKTlnr  an.l  inferior  is  Miualt-.l  a  >mall  Irianglc 
(the  ,„b,„,ipilul  iri.nii^lc)  in  whi,  h  i.  >a|...^.-.1  i1h-  |,..,l.n..r  an  li  uf  ihe  alia-, .  tosm.I  by  the  vtru-brul  artery. 

THE  FASa^E  OF  THE  BACK. 

In  the  dorsal  r.-.irion  there  are  liul  two  fa.siix  worthy  ol  note,  the-  lumbodorsal  j,!sri,i  and  l!ie 
nuchal  i<is,i,i.     ■I'hc  u!)i.i.T  layer  of  the  Hat  nutsiles  of  lite  hack  is  covered  only  by  the  .ueniral 

sil]ierruial  las(  ia. 

Tht'  lumbodorsal  fascia  I-i-s.  3;/.  10  -\;S)  is  cnmpos.d  ol  two  layers,  the  stronj^  posleri-.r 
layer,  whi-  h  i>  .-u|ienii  ially  situated  in  the  hack  and  form-  the  ai.oneiirosis  of  the  latissinnis  and 
tlu'serratiisiioslerior  inferior,  and  1  lie  anterior  or  dee;>  layer,  which  i- (l\elo]ied  only  in  the  lumbar 
region,  w  lure  the  lon.n  muscles  of  the  hack  are  included  between  the  two  laver,-. 

•I'lu'  posUrior  l.ivr  1  Fi.u's.  j^()  and  .\vS)  co\er>  the  sacro.spinalis  from  behind  and  <  Mends 
alM)\e  thi'  U]iiierm<>sl  ]iorlion  of  the  lali-imus  to  the  inferior  marj;in  ><\  ilic  aponeuro-i-  ol  the 
-erratus  jio-tiTior  sujierior.  .\|iliou,i.;h  the  fa-i  ia  becomes  .on^iderably  lliiiini  r  alliv  n  cia-c  -  to 
be  the  apoiuupwi-  .,f  the  lalissimus,  il  u -ually  ,-till  contains  distintl  tendinous  slip.s.  In  the 
thorac  ic  re::i"u  ihe  po-lerior  layer  i>  atla<  hed  laterally  to  the  an!;les  of  the  ribs,  and  i-  covered  by 
the  tra]ie/ius  and  by  till    rhomUiidii. 

•Idle  aiU.r'wr  layr  VvA-  -'.ij'  run-  from  the  inn.T  lip  of  the  .rest  of  !h(  ilium  !o  ihe  twelfth 
rib,  .m  1  i-  altache.l  internally  lo  ih,  iran-\erse  i-r.Mr-se-  of  the  lamb.ir  \irtel)ra-.  li-  upper 
niar;.'i.i  form-  ,1  lu-mer  lendinuus  band  v.iii.h  pa--e-  front  the  tran-ver-e  pn»,—  of  the  hr-t 
lumbar  \erlehra  to  the  twelfth  rib  and  i-  known  a-  the  hinih,>a>:i.il  uxl.nuil  <,nii,il,>  //,t,w;»c)i/ 
I  Kiu.  -'51  1.  'Hie  anterior  layer  i-  -ilualed  betwt  tn  the  -ac  rosi)inali-  md  the  (|uadr,uu-  lutnborum, 
an-l  at  the  outer  niaroin  i<\  the  sai  rosjiinali-  ilu'  two  l.ivers  unite  .md  ;;ive  ori^'in  lo  several  of  the 
aUlominal  mu-i  K-, 

'I'he  ihln  nuchal  fascia  i-  -iluaU'd  bene.nh  ih.'  impe/ius  and  .d-o  pa.rlly  b.nealh  the  rliom 
lK)i,|,i.      It  i-  <onlinuou-  belnw  \\\h  the  uppi  r  porli-ni  of  the  luml)odor-al  fa-cia  and  eslernally 
widi  the  fa-ci,i  of  the  niik,  .md  tlie  f.i-.  i.eof  t!ie  two  sides  .ire  ((.nnected  ill  the  median  line  with 
the  imclial  lifiamenl. 

[The  trunk  1MU-.  ul.ilur,   I-  .1.  liv..)  !'"'n  ih.  Inii.U  i..\ i-ie.  ..f  ih.  embrv..  ,,n.l  i- .  ie.irU  .hvi>ible  ini.i  nv.  |...rti..n..: 

,  ,  1  ih.  .l.>i.al  irunlv  nm^Huialur,  ,  ,1,  tixe.l  In.n,  ilu-  ,|.M-..i  i...ru..n-  ■■f  ihe  inyMtn.  . .....I  -u|.plie.l  b;.  the  .lor-al  ■  p -u  ii,.n 

bran,  he-  ..f  tlie  -puial  tierxe   ,  .in.l  i  .•  i  lb.    v.niral  Iruiik  nui- iii.eu..  ,  .lei.  I..pi  <l  ir.im  ihe  v.-nlral  p..rti..n.  ..f  ib,   trunk 
tin..|i.mi-^  ami  -uppli.  .1  b.   ihi   \'  mr.il  briii.  h.  .  ..f  lb.    ~piii.il  n.r\.'-. 

\Vh.  n  ...p-i.l.  r.  .1  fn.n.  ihi-  Man.l|«..nl.  .h.-  itm-.  1.  -  -f  ih.  1.,|.  k  a-  ati.,..*  ..  ab..i.'  .  i.  ,.r!v  f.  .nil  .i  -...n.  nhal  h.  i.r.. 
i'.ne..ii-  KP.iip  !!..■  I1..1  imi-l.-  ar,'  f-.r  the  ni..-l  pan  -iippii..l  bi  %■  niral  bran,  he,  ..I  ihe  ,piii.,l  ii.rve-.  ..i.  i.i  llie 
,,,.,.  ..(  llu  lr.UK.-ni-.  b-,  .1  .rani.il  ner^.■,  ..  (.el  «hi.h  .a  ..me  .li,iin^.ibb.-s  ih.in  l-.,iii  lie  |.,i,-  an.l  -h..rt  nuiM  le- 
t.t!.,!,,.  vulh  the-pl.nii.v.hi.  1,  (...e,  ih,-  Iru.  .l..r-..!  n.n-.  uial.in-  T  he  «iaj..ri!v  ,.f  ll...  Hal  le.,-,  I,  -  ,,re  in  r,  alit  v  nue,.  1.  s 
■  if  ih,  up|Kt  lin.b  ,,n,l  Ih,-  iraiK/iu-  i-  primarily  part  .1  lb.  .  lanial  nui- ul.ituri-.  lh.>  "ill  b.  ...ii-ei-  i.'l  Lit.--  in  ...n 
lli.!i..n   iMIh  Ihi    ..Itl.  r  Mill-  l.»  "t  lili  ir  ur..!!].- 

.-,,  (,,r  .1-  ih.-  ini.-  .I..1  -..1  imi-.  ul.iiure  i- .  -.ni  .rne.l. .  -  .n!parativ.-anal..Mn  ha-  -h..vi  n  thai  il  i-.  ..inp..-i-.l  ..f  i  • ..  p.ir.ill.  1 
ljr.„ip«  ..i  nm-.l,-,  .,  I.u.  i.il  ..n..  «hi.h  ...n-i-N  of  nui-,  I.-  priniarilv  pa^^ing  fr...ii  Ih.  lei.wv.rM  pr...e-e.<  i..  Ihi-  rib-, 
.111.1  h,  n. .    i-  l.rn.i.l  Ih.    /r.,u.rrr.... ..-/.,/  ,vr,.,./..  an.l  a  ni..r.  Mi..li.iii  ..ne,  uh..-.    niu,.  1.  .  j.a--  fr..ni  the  Iraii^-v.  rM  !•.  ih.- 


Crfmasifr..^ 
Reflectfd  inguinal  lig. 


Intrrcrural  fihm 


'  Subcutantoiib 
inguinal  ring. 


^permstif  CCd 


) 


11 


Huperior  pillar,    tundiform  lig-  of  prm's 
Fig.  245. 


Infnior  piltur. 


i-^L 


,j 


if 


_.-.\-J;_ 


XriK    ABDOMINAL    MUSCI.KS.  ^57 

as  IKCM  UTmo.1  Uu-  lr.nn:rrso..f,iw,l  Er.mp.      Tlu-  .onsliluiion  ..i  ilw  two  gr.mp-,  i.  ■>> 


spinous  processes,  and  wliiih  li 

follows:  1     ..I      ■ 

Transvers..-.oslal;-^^^m»p/.^///,^■,  /V/W«M/n.  /."^w>.,m.^<,  an.l  5/./<-",».<- 

and  obliqmis  cupitis  iiijfri,<r.  -  1  .n] 


THE  ABDOMINAL  MUSCLES. 
The  abdominal  muscles  (Ki.^'s.  .45  t"  2.0)  form  thr  anurior,  th.  laKml,  an.l  a  ,«rli.>n  of 
..ostcrioralxlominal  wall,  an.l  cxt.n.l  from  .hc  low.r  mar,,in  of  ih.  thorax  ,..  llu.  u,,pc.r  ma-^m 
■  ,dvis      Thc.v  aro  sul..livi.U.<l  into  tho  anteri.u-  abdominal,  of  whi.  h  thrcr  ■  v  Hat  muscles 
,0  a  strai-hl  muscle,  and  the  i.osterior  abdominal,  the  .|uadrams  knnhorum. 

THE  ANTERIOR  ABDOMINAL  MUSCLES. 

THE   KLAT    ABDOMINAL   MUSCLES. 

The  Hat   alxiominal  muscles  (Im,s.  .4^  l"  ^>o,  include  the  ohlu^uu^  r.Urnus.  ,he  .W^"'- 
aMomwis  i„lrnn,s,  an.l    th..   Inwsv.rsn.  Mominis;    thev   are  arran,.d   m    thne    avers  an. 
IL  the  lateral  an.l  a  porti..n  of  the  anterior  alnL-nunal  .all.     Acconhn,  ,0  .h..     ,re.  ,.on  .  f 
the.r  hber.,  the  two  ol.li.|ue  muscles  may  Ix'  r.uar.le.l  as  th..  .lirect  .-ontnnKU.on.  ol  the  inhr 
cstales,  the  obli.iuus  interna,  in  particular,  heiuK  .lirectly  .onuntun,.  .ith  the  lou.r  mter..Mal 

"""' The  obliquus  abdominis  extemus  <  Ki^s. .  ^.i"  ^  to)  is  a  broa.l  Hat  nmsck  which  i.  a,,..neu 
roti.    anteriorlv  an.l  n.arke.lly  .>  in  its  anterior  inferior  p.,r,ion.      I,   )^  situa.e.l  u,  the  la.end 
IKr.oral.  the  hyp-K  h.,n.lriac,  ih      ■pii^a.stri.,  the  meM.p.Mric  .lateral  .dKlonunal  an.l  umh.h.aL, 
an.l  the  hviK)ua>tri.  I  inguinal  an.'  pubic)  re.ui.)n-. 

U  arises  l.v  ei.ht  llcshv  serr  1  .ns  from  ,h.  .  i.h,  .f.fth  „.  lu.lf.h)  low.  r  rd.  Uu-  upp.r  hu- 
.,n-a,ions  inlenli.ilalin^  uhh  tlu  .w.  r  on.  s  „f  the  M.rra;us  ant.rior,  .he  l..u.r  three  wth  th..se 
,„■  ,lK.  latissintus  .l.nsi.  The  mai..ri,y  ..f  .he  lib.  -.  of  .he  musd.  ,  like  those  ol  .In  umMvostales 
..Mcrni.  .-un  from  above  .l.nvnwar.'  Mi.l  fn.n,  uid,..u,  inwar.l;  ih.-  sup.iMM-  1,1k  rs,  ho^.x.r,  ,,as> 
M.m.A...al  h.H-i/,nntahv,  uhile  the  ,.  feri.M- ...us  app.-..a.  h  a  veru.  al  .Inv.  ...m. 

Tlu.  hb.r,  ...nin..  In>m  the  ower  ribs  Iunc  an  .vt.n.ne  ll.shy  .nMnnn,  ,n,..  .lu  .uU.  r 
,;„  „r  ,h,^  ,n~l  of  th..  ilium,  eMen.li.tK  an.eri..rh  ...  .!>.■  ar,.,  ri..r  su,..ri..r  ^.n,.  and  p..s.ei-,n,U 
Jnt..s.  ...  .lu  -..r  nK>r,in  of  the  bussinu.s  .lor^i.  Tlu  ...main.l.  r  .,f  .h.  nw  r.,on  ,s  ap..n..,r..ti. 
,n,l  ,,,....  ,„  ,he  ,nuui,tal  ,|-..upan's,  liKam.nl,  .he  U-valer  p.,.-.ion  ..I  wh,.  h  ,~  lorm..  bs  th. 
^,,,,in..us  fasu.uh  of  ,lu.  n,us.le  .sc..  pa,e  ,(.,..  an.l  .0  .h..  :o,„  ,  mr  laxer  „.  m,  sh.a.h  oMh. 
rectus,  bv  m.  an,  of  .  hu  h  ,,  is  .  ..nnnu..!  m  .h.  Inu  ,.  ..Iba.  \lmo-.  .lu  ■  n.n-.  an-eruu-  ab.  .m.nal 
surface  is  .  ..n...,uen,ly  ap..neur.,.i.  .    esp..  iallv  in  .lu   lou>  r  ab,i..nunal  r..,i..n  .h..  mus.  le  hlH.s 

i.mimeiue  .luit.'  at  ih..  sidi..  ,   ,       ■     ,  s 

....        ,..  ,   1   ,..;,.:     ......_ ;.   ,  .   ,-..l,i;,»,  Mii.rri.irh    v.i.h  .lu     ilKlomiiud  p.H-li.>n  ol 

,lH.  ,.ec...r,dis  mai,.r,  .Memallv  wi.h  the  s.  rralus  anteru.r,  p..s.en.  eM.rnally  u„h  .h.   la.,ssM„us 
,i„r'i.  vsi.h  uhi.h'  i.  f.mns  the  hnubar  >I'elil's)  triangle  (see  page  i^V-  ami  mteru.rly  u.lh     -c 


X58 


ATLAS   AND   TEXT-BOOK    OF    HU.MAN   ANATOMY. 


Flc.  247. — The  su[)crficial  lavtr  of  the  aluJomiiuil  musilcs  and  llic  serrutus  anlcior  >ci.'n  from  the  left 

Till'  pirtorali.^  iiKij<ir  and  minnr  ami  the  innir  porticm  of  the  clavicle  have  Ix/cn  rcmiivcd  ami  tlie  arm  has  licen 
'Iraun  Ikh  k\\ai«I. 


iliac  crest  opposite  to  the  f;luta:us  niedius.  In  the  rcj^ion  of  the  symphysis  pubis  the  tendinous 
libers  uf  the  ajioneurosis  form  an  openini;  by  bridsjini;  <)\er  the  space  between  the  pubic  spine 
(the  insertion  of  the  ini^uinal  ligament)  and  the  ujiper  margin  of  the  symj)hysis.     In  this  manner 


(V)Uquus  iihilnmiii!^  rxlrrniis 
Miisflr  siirjiirc         .  I  pmicuritsix 


f.iiici  iilh.i 


hitir,r :■-,!!  fihrrs 

.Su!>rri,ir  i-illar 
Sttht  itl'iiii-owi  int^uiiiiil 


lil]iriiir  piliir  [iitl^uithl I 


.XiUrrior  stt furrier 
sffitic  vj  ilium 


hi^uhml  /ii^'int'  nf 


.Icil'thulum 


V  Symphysis  pubis 


I  ti;.    :  t"    -Iii.iKr.iiii  .f  ihi-  >ul«  ul.mii'ii^  inguinal  riiip.     On  tlte  rinlil  only  ,1  |Kirllun  m'  ihi-  .i|Hini-urci-is  nf  ihr  olilirjuurt 

.ilMliiMiinis  is  riprrsented. 


ihrrc  is  t'orni((l  a  iriangK',  the  outer  angle  of  \\liich  i-;  direcled  upward  and  outward,  ami  which 
((>n>tiluiis  tile  siihi uliiiuotis  iiif^uituil  {iwlirnal  abdominal]  rim^  (l''ig>.  245  and  ?4'>).  'I'he 
margins  of  tiic  ring  arc  formed  by  the  ajioneurosis  of  the  obli(|uiis  abdoiuinis  externus,  and 
are  known  a-,  llu  sii f'triar  (riis  or  pillar  and  the  nijtrwr  trus  or  pillar  ol  ihc  ring. 

The  upper  and  outer  angle  of  lhi>  ..iangular  >lit  in  the  apoiuunois  of  the  external  obli(|ue 
muscle  is  rounded  off  by  lilxrs  which  arise  from  the  region  of  the  inguinal  ligament  and  arc 


^^v^V',  .w-f-i^-^^^J' 


Clavicle  .< 


Omohyoid 
Scnleniis  medius 


Sternohyoid 
+  Sternothyreoid 


Scalenus  anterior - 


Pectoralis  minor 


Pedoralis  major/ 


Fig.  247. 


ill 


:  it 


.V^:\.^;-,^!„^:v,Vv^'  ^-V  ..:  :r>:P^     jYM^m 


Hi 


-L 


^f^lgj^g^..  ... ..,  :W-^^m^    .  :^;-C'',.;y;:<a^..:  Wmm.^ 


THE   ABnOMINAL   MUSCLES. 


I5Q 


situated  superficially  and  in  front  of  the  aponeurosis  itself.  They  arc  known  as  llie  iitlrrrrural 
I  inlcrcoltimnar)fihirs  or  ihc  anterior  cms  or  pillar  (Vl'^s.  24^  and  24(}).  The  inner  angle  is  similarly 
rounded  otT  by  fibers  of  variai)le  development  whieli  originate  at  the  attaeh.ment  of  thi'  inguinal 
ligament  to  the  jjiibic  sjiine  and  jiass  toward  the  linea  allxi  beneath  the  ajioneurosis.  These 
fibers  are  known  as  the  rr/Urlnl  iiii^uinal  {triangular)  tii^amcnt,  or  sometimes  as  the  lii;amrnt 

Slicalli  I  j  rri/iii  dhji'tiiinis  .  I /»>i!f«r.i.w>  »/  Afioiiniriisis  I'J 

((inlcrior  layer)  ohliquus  ,ihdomiin\  rxirrinis         ohliquus  .ilxtomim^  inleriius 


1  (IHiquiia 
\  rxlrnius 
I 

}  nilcrni'S 
I  r<tns- 
it  rstis 


Fir..  2.4s.— Tr;in-vir~f  ^nlinii.if  thr  .-intrrinr  :itK|iimin:il  \v:iU   .ilnmt  a  h.ind'^  hriv'.illh  :ili'ivr  llii-  iimliilit  u>  |ili.it;r.un- 

niatii  !. 


Sliciiili  «j  rriiuf  .ihliiminh  [anterior  layi-r) 


A/MinruriiuK  nj  dliliijiiu^  .iMomiiih  iiiirriui^ 

Apont'uriisii;  oj  obliijuus  aMi'iriiins  fxlrrntfi 


'.     I  >lHi(jlllt.S 


ti!fir:nts 
/  r,nn- 


I'll;.   24').     'I'raii-vc  r-r  M  dion  of  ilu' aiitiiicir  Ml"l'>min.il  w.ill   miilw.iy  1h  Iw.-i  n  tin-   iimhilii  lis  ami  llu-   -Mti|ili\ -i^  pulii-. 

i<liaKrani!ii.ili(  ). 


oj  Colics  or  the  posterior  cms  (Tigs.  24^  and  24(1).     .\s  a  nsull  of  the  iiresenc c  of  the  tibers  and 
the  ligament,  the  .ing  biionus  irregularly  ijuadrangular  in  >liape. 

It  is  tile  antirior  extremity  of  a  laiiat,  the  inguinal  (anal,  whidi  passes  obli(|uely  thnnigli 
the  abdominal  walls,  and  transmits  the  spermatie  eord  in  the  niaii ,  and  the  round  ligament  ol  the 
uterus  in  the  female. 


'  i| 


il-nr  a  mnrr  ilii.iili'H  .-iiTount  of  ihi'  inguiniil  <  anal  tin   rcadir  i..  nfirnil  to  ti\i  li<i.ik~  ami  allasi-.  of  to;iiigrapliii 
anutomy  ami  lo  the  ^idion  upon  ■.plani  linologv .  i 


^e 


160 


ATLAS    AND    TEXTBOOK    OF    HUMAN    ANATOMY. 


Fig.  250.— The  deeper  layers  of  the  abdominal  muscles. 

On  the  loft  side  thi-  anterior  laver  of  the  slu-ath  of  the  rectus  alxlominis  and  the  obhciuus  abdominis  exlernus 
have  been  removed;  on  the  riRht  side,  in  addition,  the  reetus  abdominis,  the  pyramidalis,  and  the  obli<iui's  abdomuns 
internus.     The  cNternal  intereostal  ligaments  have  l)een  removed  im  the  left  side. 


1 

I 


The  obliquus  abdominis  internus  (Fi,a;s.  245,  248  to  250),  like  the  cxtcrnus,  is  a  decidedly 
flat  mustk.  With  the  e.xeeplion  of  tile  ;ill  area  in  the  lumbar  triangle  it  is  eompletely  covered 
by  the  obli(iuus  externus.  It  arises  from  almost  the  intire  len-^th  of  the  middle  lip  of  the  crest 
of  the  ilium,  extending  anteriorly  as  far  as  the  anterior  superior  sjiine,  from  the  junction  of  the 
two  layers  of  the  lun  bodorsal  fascia  (.see  page  156),  and  from  the  outer  two  thirds  of  the  inguinal 
ligament.  The  direttion  of  the  I'lbcrs  of  the  u])i)er  yxirtion  of  the  muscle  is  similar  to  that  of  the 
intercostales  interni  (from  without  inward  anfl  from  below  upward);  the  middle  fibers  are  less 
ol)li.lue,  and  the  lower  ones  are  horizontal,  those  of  the  lower  third  even  passing  slightly  from 
without  inward  and  from  ab'ne  downward,  like  those  of  the  obli(iuus  externus. 

The  i)osterior  fibers  u  g  from  the  lumbar  fascia  have  fleshy  insertions  into  the  lower 
t)orders  oi  the  three  lower  ribs.  The  long  fibers  < oming  from  the  iliac  crest,  as  well  a.s  the  hori- 
zontal and  descending  fasciculi  from  the  inguinal  ligament,  i)ass  into  the  sheath  of  the  rectus, 
the  two  lavers  of  which  are  formed  by  the  aponeurosis  of  the  obli(|UUs  internus  (Fig.  248). 

The  muscular  i)orti<iii  of  the  obliquus  internus  is  broader  than  that  of  the  externus  and 
conse(iuentl}  ipjiroaches  muth  more  closely  to  the  sheath  of  the  rectus  in  the  anterior  alxlominal 
wall,  especially  in  its  lower  jioriion  (Fig.  24.)).  .\  variable  number  of  the  inferior  libers  of  the 
obliquus  internus  actompanv  the  sitermatic  cord,  as  the  rrnua.slrr  (Figs.  245  and  250),  as  far  as 
the  testicle,  and  conse(|uently  pass  through  the  external  abdominal  ring  as  flat  isolated  fasciculi, 
and  in  the  female  a  few  fibers  of  the  muscle  are  similarly  continued  upon  the  round  ligament  of 

the  uterus. 

The  transversus  abdominis  *Figs.  24S  to  2501  is  a  flat,  rather  thin,  and  largely  ai>oneurotie 
muscle  which  is  completely  covered  hv  \hv  obli<iuus  internus.  It  arises  by  flat  mus(  ular  serrations 
from  the  inner  -urfate  of  ihe  six  lowtr  libs  and  from  the  cartilages  of  the  seventh  to  the  tenth, 
interdigitating  with  th.  m  rrations  of  origin  <d"  ihi  diaphragm  (see  page  i()4i.  It  also  arises  by  an 
ajxineurosis  from  the  entire  kngth  of  llie  jundion  of  llie  two  layers  of  the  lumix.dors.il  fascia, 
from  the  iniernalli])  of  the  cri-i  of  the  ilium,  and  from  the  outer  third  of  the  inguinal  ligament.  The 
fii)ers  jKiss  almost  transversely  and  are  altadud  lo  the  aponeurotic  insertion  in  a  curved  Ime. 
the  sniiiliiiutr  line  iliur  oj  .S/j/i,', //;/ >  ■  T'ig.  2^01,  in  su<  h  a  manner  that  the  uppermost  libers 
coming  from  the  ribs  alnio-t  apprtnuh  rath  other  in  the  median  line,  the  middle  ones  become 
aponiurotii  at  ((uite  a  dislantc  from  thi-  loialioii.  and  the  inferior  fasiitiili  rtmain  muscular 
for  a  somewhat  greater  distance.  The  upper  uvo  thirds  of  iht  aponeuro-is  of  the  trans\ersus, 
tog.ther  witli  that  of  ilu  inlernus,  form  the  ])ostirior  layt  r  <d'  the  >heath  of  \hv  rulu-  (Fig.  2,48); 
the  lower  third  together  with  the  aixineuroses  of  the  obliiiuus  internus  and  externus,  forms  the 
anterior  l:;vcr  of  the  ^heatb  (Fig,  ?]■■}''■. 


i 


External  intercostal  ligts. 


Obliquui  abdominis 
intfrnus  :■: 


Cremaster 


Interrostale-  iiiterni 


Sirratus  anterior 


Internstales  externi 


Oblitfiiiis  abdo- 
minis externus  x 


Cremaster 


m 


FifT.  250. 


Is    \ 


^ 


THK    AIJDOMINAI,    MISCI.KS. 


I6l 


THE  STRAIGHT   ABDOMINAL   MUSCLE.   RECTUS   ABDOMINIS. 

The  rectus  abdominis  (Fi^s.  248  to  250)  is  a  tlat,  broad,  and  rather  thick  mu?clc.  It 
arises  (Fij,'.  250)  l):-oadlv  by  Hat  imis<  uiar  serrations  from  the  cartila.tres  of  the  tlflli  l.i  the  seventh 
ribs  and  from  the  xiphoid  imx-ess,  and  its  libers  ]iass  almost  vertieally  downward  iu>t  to  eidier 
side  of  the  median  Sine.  The  muscle  becomes  somewhat  narrower  as  it  descends  .md  is  inserted 
by  a  much  narrower  tendon  into  the  ujjper  border  of  the  i>ubis  between  the  pubic  luliercle  and 
the  symphysis,  a  portion  of  the  tendinous  fasciculi  of  the  muscles  of  the  two  >ides  inlerlacinu  m 
front  of  the  ptibic  syn-'physis. 

The  rectus  is  '-haiacteri/.ed  by  possessing  several  narrow,  transverse,  sli.i;htly  curve<l  or 
dentate  tendinous  intersections,  the  tendinous  inscriptions  ^transverse  lines)  (V'v^.  2;pi,  which 
traverse  a  jjorlion  or  the  entire  width  of  the  muscle,  but  do  not  usually  cMenil  throu.uhout  its 
thickness.  'Fhe  number  varies  between  three  and  lour.  The  uppermost  one  lie-  immediately 
below  the  orii;in  of  the  muscle  in  the  re,i,'ion  of  the  costal  arch  and  is  sometimes  develop.'.l  onlv  in 
the  inner  half  of  the  muscle;  ih.e  third  is  situated  at  the  levil  of  the  unibilu  us  or  Mimc'what  above 
it;  and  the  second  is  about  midway  between  the  first  and  the  third.  .\  ourili  intersection  is 
inconstant,  but,  when  present,  Is  below  the  umbilicus  and  usually  tra-.ersts  only  ilie  oute"  half 
of  the  muscle.  In  the  vicinity  of  the  tendinou>  inler>e(  lions  the  muscle  i-  a  llurenl  to  the  anterior 
laver  of  its  .-.heath. 

Instead  of  beinj^  surrounded  be  fascia,  the  re(  tus  is  inclosed  by  the  aponeurotic  layers  of 
its  sheath  (Fi-^s.  245,  247  to  2;oi,  which  loiisists  of  an  anterior  and  a  poslcTior  la\cr.  Only  the 
anterior  layer  covers  the  mu.scle  throu.-jhout:  the  posterior  layer  forms  a  sheath  for  only  the  ui)i)er 
two-thirds  of  the  muscle  (Fifis.  24S  and  24(1).  .\t  the  juncti<Mi  of  tiie  middle  with  the  lower  third 
of  the  leu.ulh  of  the  muscle  (or  even  somewhat  hii,'her>  the  posterior  layer  of  the  rectus  sheath 
abru])tly  ceas'  in  the  shape  of  a  slightly  curved  line',  the  semieireular  line  {line  oj  Ihiii^las)  ( Vvj,. 
250),  and  below  this  line,  the  muscle  is  in  immediate  relaticm  jiosleriorly  with  the  transversidis 
fascia  (see  page  i(),^). 

The  layers  of  the  sheath  are  formed  from  the  Hat  abdominal  muscli's  (Figs.  24S  and  240 1  in 
such  a  way  that  the  ajKmeurosis  of  the  obliquus  internus  splits  into  two  layers  in  the  upi)er  two- 
thirds  of  :he  sheath,  one  of  which  forms  the  anterior  layer  and  the  other  the  jio^icrior;  in  the-  lower 
third  of  the  rectus,  h;iwever,  the  aponeurosis  of  the  ol)lic|uus  internus  forniN  only  the  anterior 
layer.  The  ai)oneurosis  of  the  oblicpius  externus  ji.-i.ssc^s  into  the  anterior  layer;  the  upjier  two 
thirds  of  that  of  the  transversus  goes  to  the  posterior  layer,  and  the  lower  third  to  the  anterior 

layer. 

M  the  inner  margin  of  the  rectus  the  two  layers  of  the  sheath  unite  with  eac  h  other  and  with 
the  corresiicmding  lavers  of  the  opjjosilc  side  u>  form  a  thick  tendinous  strip,  the  ///;'((  <//.'"'  (Fig. 
245),  which  extends  be'.v.een  the  xiphoid  jiroces-  and  the  sternum. 

Th.  linea  alba  ustially  ])ossesses  a  spec  ial  tensor  mu-  '    in  the  shai)e  ol  the  inconstant  pyra- 


midalis  'Fig.  2-0;.     Thi-  is  a 


.r;.^„,,r,,i;,,-  iTjrf.rle  .'.risin''  broadlv  fnjm  the  tenclon  of  insertion  of 


the  rectus  alxlominis  and  passing  obli(,uely  inwarci  to  be  inserted  into  the  lower  jwrlicm  of  the 
linea  alba. 


\e 


m 


Mi  I 


162 


ATLAS    AND    TKXT-BOOK    OF    HIMAN    ANATOMY. 


The  rectus  an<l  pyrami.Uiiis.  like  the  other  museles  of  the  anterior  aliiloniinul  wall,  are  innervate.l  by  hranrhes  of 
the  lower  iptereostal  inrve^;  the  Hat  alKiomina!  muscles  also  receive  branches  from  thi-  iliohypoKastri.  anil  the  ilio- 
inguinal nerves  fVoni  ihe  lumbar  pleNUs,  The  .  remaster  mus,  U-  i>  supjihcd  by  the  cNternal  spermatic  nerve  (the  genital 
branch  of  the  genitoi  rural  nerve). 

When  all  the  aiUi  rior  abdominal  muscles  ad  together  their  function  is  to  diminish  the  si/e  of  the  alRlominal  cavity 
and  to  compress  the  abdominal  <  .niienis,  the  inc  reased  intra-abdominal  tension  aidins;  in  the  ev.,.  uaticm  of  the  contents  of 
the  intestine -,  of  the-  uleru>,  and  p.is>ibly  aUo  of  the  urinary  bladdc-r.  W  ith  the  exception  of  the  transversus  abdominis, 
lhe>e  muscles  also  draw  the  thorax  downward,  the  rectus  directly  downward,  and  the  ol.li.|ui,  when  .acting  scjearately, 
toward  the  side  of  the  c  ontrac  tinj;  mu^le.  Whc-n  the  thorax  is  l.sc-d,  the  anterior  abdominal  mus,  l,s  and  particularly 
the  rectus,  raise'  the  pi  Ivis. 

THE  POSTERIOR  ABDOMINAL  MUSCLE. 
The'  quadratus  lumborum  (Fi^s.  251  and  -'54)  i^  '^  llaik-ned,  rather  tliirk,  and  apjiroxi- 
niatilv  (luadrilak'ral  muscle  which  forms  a  jiortion  of  the  ])<)sterior  abduniiiial  wall.     It  extends 


Thordck  vrriihrd  .\  1 1 


Lumbar  verttbra  I 


;i;timcnt 


T:  -tilh  rib 


Lumbar  vertebra  V 


Iliitlumbar  il^-iiiu'U 
Fig.  251. — The  ipi.iclratus  lumborum  seen  from  the  sicle  anci  somewhat  from  behind  idi.iRran:matir). 

between  the  (rest  of  the  ilium  and  the  iwelflii  rib,  and  consists  of  two  incompleK-ly  sepanited  layers, 
a  posterior  and  an  anterior.     The  [x'slrrior  portion  1  Fig.  251 )  arises  by  ajKjneiirotic  libers  from 


THE    ABDOMTNAI.    MrSCI.I  S. 


thi'  jiustv-rior  ]);irt  of  llu-  intu  r  lip  of  tlu'  crc-t  of  ihi'  ilium  and  from  tlu'  .liolumhai  '  i;amfnl  anil 
;;  .  lo  ihu  inner  half  of  thi'  lower  bonier  oi  ihc  tui'lfth  rib  and  lo  Ik  trans-ersc  procoM--  of 
the  iij)]ier  four  lumbar  \i'rtebra'.  The  diUcrior  portion  of  the  muMli  arise--  from  tlu'  transverse 
proeesses  of  the  loWiT  and  middle  lumbar  wrtebra',  tlie  fibiT^  iiilimali  l_\'  iii'  ilacint;  with  ihnse  of 
the  ])()sterior  portion,  and  inserts  into  ihe  lrans\erse  proeess  nl  ilu'  fir-t  lumbar  \ '  rtebra  and  into 
the  inner  lialf  of  the  last  rib. 

The  inner  half  of  the  <|uadratus  kmiboriim  is  pLiced  beneath  (po^iirior  '.■  ■  ihe  p~oas  major, 
and  it  is  situated  in  front  of  tin  anterior  layer  of  the  lumbodorsal  fas(  ia.  «  hi.  h  sejiarales  i'  from 
the  sacrospinalis.  The  lateral  limiboeostal  anh  leMi  rnal  annate  liu'ameni  of  the  diaphragm 
bridges  over  the  insertion  of  I'le  musele  into  the  twilfili  rib.  To  the  outer  sidi  of  ihe  mu^i  le  then 
is  visible  ; he  aponeurotie  origin  of  the  transvi-rsus  abdominis  from  the  i'.inibodorsal  fa^iia,  and 
at  the  crest  of  the  ilium  it  bo    '        :   on  the  iliaeus. 


n 


Tlir  >!U.i(lratus  lu?iil«iruni  is  sup]ilic'il  liv  musi  ul:ir  liranc  tic<  from  tin'  lumbar  plrNu^.     It  ilraw-.  '1:.    la-i  ril-    Inwn- 
ward  ant!  iK-nii.s  llio  vrlihral  mlunui  Imvaril  tin-  ^iilc. 


THE  ABDOMINAL  FASCIA. 

The  superlk'ial  layer  of  the  llat  abdominal  museles  is  rovi-red  only  by  iht-  i^ciurdl  siipfr:u  i,il 
ja.scid  (Fips.  248  and  240),  which  i>,  however,  well  de\elo])i(l  iii  the  lower  portion  .4'  the  abdomen 
in  the  refjion  of  the  subcutaneous  inguinal  rinf^,  where  it  forms  what  is  known  as  Srarpii's  jasrio. 
From  this  situation  it  extends  downward  upon  the  thigh  and  also  envelops  tin-  spermatii  cord  as 
the  cnmaslerk  jascid.     The  sheath  of  the  rectus  musele  serves  as  its  I'asc  ia. 

The  inner  surface  of  the  alxlominal  musculature,  i.e.,  tlie  inner  ^urfaie  of  the  transxersus 
alxlominis  and  the  posterior  surface  of  the  jiosterior  layer  of  the  sheath  of  the  rectus,  i-  lined  by 
the  Ininsvirsalis  lusciu,  which  also  covers  the  anterior  surface  of  the  ([uadratus  limi)M)nini  :in<l  is 
especially  strong  over  that  mu.scle.  It  is  rallier  llrmly  adherent  to  ihe  aponeurosis  .4'  die  iiinis 
versus  and  to  the  posterior  layer  of  the  sheath  of  the  rectus;  lielow  the  semic  irctil.ir  lim  ii  is 
fre(|uently  very  thin  and  forms  tlu  inly  posterior  cowring  of  the  rectus  alxlominis  isd.'  ijage  idi 
and  Fig.  :}4()).  .\bo\e  the  symplivsis,  it  is  connected  with  th(  -o-called  iidmininilum  Ihuir 
alha-  isee  below),  and  at  the  inguinal  (I'oupart's)  ligament,  with  the  posterior  surt'aci'  of  whi.  h 
it  is  adherent,  it  becomes  continuous  with  the  iliac  fascia  (see  page  2,^1).  Supt'riorly  the  fascia 
gradually  (lisap])ears  upon  the  lowi  r  surface  of  the  ciiaphragni. 

The  liiua  alba  (Figs.  245  and  248)  is  formed  by  the  union  of  the  aponeuroses  of  the  llat 
alnlominal  muscles  in  the  median  line  of  the  abdomen.  It  i>  broader  alnne  than  below  the 
umbilicus  and,  at  the  umbilicus  iuelf,  ii  i-  adh<Tent  to  the  integument.  At  its  insertion  ii:!;;  the 
upper  margin  of  the  symphyseal  cartilage,  its  jiosierior  surface  is  reinforci'd  by  a  triangular  fibrous 
expansion,  Mimetimes  containing  muscle  fibers,  which  passe  u]jwar(l  from  the  sujaTior  jiubi. 
ligament  ,iiid  is  k^:0^.■n  as  tin-  iidminii  itlitiii  lii-nr  alhcr. 

Tlu  iiif^uimil  lii^iuuiii/  .  I'oupart's  lii:;ami)u '  1 1'ig.s.  208  to  j  10  i^  also  formed  bv  the  a[)onni- 
ro.ses  and  fas(  i.e  of  <he  alxlonien.  It  extend-  as  a  strong  tenilinou-  band  from  thi'  anterior 
SU|)erior  -pine  (4'  the  ilium  to  the  spine  of  the  |)ubi.-,.  some  of  its  libers  radiating  at  its  insertii'ii 
to  the  inner  exlremiiy  i4'  the  crest  of  the  jiubis  and  funning  an  almost  hori/.ontal  triangular 


vn 


^^i^^a 


J-i^^r4 


'T 


m 


164 


ATLAS    AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 


Fig  2C2 -The  diaphragm  ami  the  muscles  of  the  posterior  abdominal  wall. 

The  interior  Abdominal  ..II  an!.  >h.  ahao.ina.  v,s..ra  have  bec-n  removed;   the  thorax  has  been  bent  back.ani 
so  that  the  lumbar  vertebne  are  stronnly  convex  forward. 


I|! 


ligament,  the  lanuu.r  li,a,nn,t  (Gimbernars  ligament)  (Figs.  212  and  21,,)  which  is  also  con- 
n  ccd  w'ith  radiating  f.hcrs  of  the  fascia  of  the  thigh  ,sec  page  2,.).  The  n//..  <</  u^,u,nal 
"  Ln,  Urnn.„.larli,.n„cnn  (Fig.  24..  is  also  formed  by  radiating  filx-rs  from  the  mgumal 
i  ament  whi.h  pass  to  ,he  posterior  surface  of  the  anterior  layer  of  the  sheath  of  the  rectus  ,sec 
pa  e  ;  ').  The'inguinal  .i  ament  gives  origin  n.>t  only  to  the  Hat  alxlominal  muscles,  but  U  also 
lurnishl  attachment  to  the  fascix  of  the  alxlomen  and  thigh  (see  page  231),  and  the  deeper 
layers  of  the  integument  are  also  adherent  to  it. 

rrh>    ventral  ,,or.io,.  of  ,he  trunk  mvotonu.  during  their  development  undergo  a  eo-^uWrable  -'"""'  "f'";'- 
1  '">    \wiii.ii  I   ..i.  „,,,,,,,ni..   1  i>..rtiiin    <  1  ut  off  whieh  eomes  to  lif  ventral  to 

,,,n-iitute  uhal  i>  known  as  ih.'  oblique  group  of  nuisdi's. 

•n„.  alHlominal  mvw.  le<  aie  r,  1.  rable  to  thoe  group-^  as  follows: 
UyiKiskelelal;   /N.'./<  '«.',/'"•  and  pso.is  mi<wr  f-^v  p.  -M0>. 

ObUMue      <V./;,„„.   .,1.1 i..is    .:.',..,.   ,Hi„ .Mo„un.    n..rnu.s.   .ran.rr >,,o„u,ns.    and    ,u„^r.U.s 

^ ';:;:  ,,..  ,.„,,.„U.  ,ha,  ,he  ..,W.„nv.M„n,  /.,..„/,•.  „,  ,he  luml. .ion  are  pro,.rlv  referable  to  th.-  obli,,ue 


t;roiip 


-V.i>,| 


THE  DIAPHRAGM. 

•Ihe  ,naphra„n  .Fig.  2,2^  is  :.  singl.  independent  muscle,  whit^  from  a  ,opognt,Oncal 
.tandpt.int.  is  IkM  ...nsi.lered  with  the  abdnnnn.tl  muscles.  l,s  shape  .l.lTers  from  ,ha.  o  a  1  he 
. Ir  skele  al  ntusdes.  in  iha.  i,  is  a  ,hin  and  n,arkedly  donw  sitaped  musde,  u  u  h  ,s  stretched 
,  OS.  the  infeiior  ape,U,n  of  the  thor^.x  in  sut h  a  wav  tha,  i.  is  convex  t.nvanl  he  horax  an. 
;;;,,,..  ,„.,,d  Ihe  Ul-men.  I,  tonsi-.s  of  a  .tniral  tendintnis  portion,  the  ,nUr.l  inulou,  and 
of  a  I ierii)herial  muscular  portion.  .  •     •   .    .1., 

•Itc  mustular  fas.i.tdi  of  ,lu.  diaphragm  are  s,i!.,!ivi.le.l  according  .0  the.r  or.gm  m.o  thret^ 
,,.r..  .l.i.h  are  .lesi.nate.l  the  s„nuH  portu.u  .he  a.,ol  porUo,,.  and  the  lu,nhar  parUon  and  o. 
llHM  the  lumbar  ,K,rtion  is  the  strong.  M  an.l  tlte  st.  rnal  p..r.ion  by  far  the  weakest.  I  he  IdnTs 
„f  ail  three  iH,rli..ns  are  inserted  into  the  margins. d- Ihe  Mtttral  tendon. 

T,,,  Lu,l  poruon  .Figs.  252  an.l  2.3)  arises  fn-n  the  ,K,s,en..r  surfa...  .,.  the  Mph.„.l 
-.rocess  an.l  ...nsisis  .d'  but  a  few  slender  fasticuli.  .        .  ,     ■ 

■n,.  „..M/  por,i Figs.  2,^  an.l  2,,,)  arise,  by  br.,a.l  tUshv  serrat,..ns  fr.-m  the  mner  s  r. ace 

'  '  ,  ..         .•       !       ,-•. 1 if.V.  rllvu   lu  inn  :iUi.  atta.hed  to  liie 

,,f  Ihi  >i\  low(r..>staiiariiiagesarid  iromtneeie-.viiin.jTiM  -  ■ 

,umlK.c..stal  liganunt  in  this  situati.m.  interdigita.ing  wi.it  the  tran.sversus  alKl..nun.s  and  w.th 

ansvt  r.,s  th.,nu  i.  f..il.nving  the  curvature  ..f  tlu  .iome  of  the  tiiaphragm  and  passing  ...the 

U     1  ,en.lon.     Tlu   hbers  of  this  .K.rl.on.  alth.-ugh  weaker  than  those  of  .he  lumbar  portion. 


L^S^:<^\: 


Opening  for  the  vena  ca 


^^      Otsonhageal  opening         Oesophagus  ^ 


Internal  liimbo- 
costal  arch 

External  lumho- 
roslal  arch 


Fig.  25J 


1 

1^ 

■,!f:  , 

«  -  1 

I  i 

u 
■■■  1 

s    1 

J     t 

■■     i 

I  i 


t    ! 


f 


THK    AHDOMINAI.    MI'SCIKS. 


I^S 


cover  a  much  larf^cr  area  and  form  the  main  iiortion  of  the  dome  of  the  (Hajihrasim.     rutween 
the  individual  serrations  of  origin  there  are  sometimes  Unear  intervals  whieh  eoiilaiii  no  museular 

tissue. 

"T^he  greater  part  of  llie  liimlnir  porlioii  i  Fig.  252)  comes  from  tlie  l)o<he>  ol  th.-  himhar 
vertebrx. "  Ujion  either  side  tiiere  ay  l)e  distinguished  three  crura,  or  pillars,  the  <rii<  malialr, 
iHlcrmrdiiim,  and  klvrak.  The  iiuur  <  r»n;,  sometimes  termed  simply  the  crura,  are  l.y  far  llu- 
wrongest  parts.  They  arise  Ijy  lemhnnus  fibers  from  the  anterior  surface.-  of  the  third  and  fourth 
lumbar  vertebra-  ami  from  the' anterior  longiludiiial  ligament  and  the  inlervcrleimd  libnn  arlila-c 
between  the  two  vertebra',  ami  their  outer  margins  s(K)n  become  muscular  while  the  inner  .^nes 
remain  tendinous.  Thev  may  arise  ..!  different  levels  on  tlu  two  -ides,  and  when  this  is  the 
case,  it  is  the  ri-ht  cr  .  which  is  always  the  longer  of  the  two.  The  imur  t.  ndinou-  margins  unite 
at  the  level  of  the  twilflh  thora.  ic  vertebra  or  at  thai  of  llu'  eleventh  inler\c  rlebral  fi!>rocarlilage 
to  form  a  i.ointed  ar.  h  with  tendinous  margins,  w  ..k  h  is  converted  into  a  short  canal  l.y  the  anterior 
surfaces  of  the  last  thoracic  and  the  lirst  lumbar  vertebra.  The  opening  so  formed  gives  pa>sige 
to  the  aorta  and  i-^  c.m->e«|uently  <lesignaled  the  iinrlir  ofiniiiii^  iFig.  2-^2). 

The  filHTs  of  the  entire  lumbar  portion,  and  especially  those  of  the  inner  crura,  pas>  at  lir>l 
almost  verticallv  ^  wanl  in  front  of  the  lumbar  column,  but  juM  l.efon'  their  insertion  into  the 
central  tendon  iliev  follow  tlie  curvaluiv  of  the  diai.hragm,  and  in  thi>  situation  they  inclose  a 
sc.nd  opening  in  the  diaphragm,  which  is  elliptical,  the  long  axis  luing  vertically  i>lace(l.  The 
margins  of  the  foramen  are  purely  mu-cular  and,  as  it  gives  passage  to  the  es,,phagus,  it  is 
known  as  the  esophageal  opening.  In  its  formation  there  usually  occurs  a  decussation  of  the 
libers  of  the  two  inner  crura. 

The  iiii.lill,'  <riira  are  considerably  weaker  and  more  slender  tli:in  the  iimer  ones.  'I  hey 
arise  bv  short  tendon-  from  the  lalend  surfaces  of  the  bo,ly  <,f  the  s.'i  ond  lumbar  vert,  bra  and  are 
at  first' sei-arated  from  the  inner  .rura  by  narn.w  slits  but  belme  their  insertion  into  the  .entral 
tendon  thev  Iwcome  closel>  appri>\imated  to  the  miisi  ular  tissue  of  tin  m. 

The  otiuririiy^i  practicalh  arise  from  the  luo  tendinous  hanibocosial  an  lies,  the  inlirwil  ,.ih1 
vxurual  lumbon,./,,!  „r.lus  „/'/•-/;,  ^  ,<l  lhil!,r^.  Tlu'  inimuil  linnh,„osl„l  ,inh  uiWru.il  .mti.U. 
li^^amntn  passes  from  the  Ix-ly  of  the  lirsi  lumbar  Vi-rtebra  to  the  ti).  of  the  transverse  pro.  ess  ol 
ih,^  s.nne  Ix.ne,  crossing  over  the  psoas  major,  while  the  ,xl,rn.:l  hiwho, osl,il  ,inh  nxhni.il 
arnuil,  lii^.iwnih  e\t.  n,ls  from  the  transvers,  pro,.-  ..f  the  lirsI  lumbar  veil.bra  to  the  tvv.  lllh 
rib  an.l  bri.lg.  s  ov.r  tiu'  ,|ua.lr.iins  lumlK-ruin.  Tlu-  sl.ii.U  r  Ob.rs  ,.|  the  lateral  lumbar  |«.riion 
Hi  the  diaphragm  ari^.'  chi.lb  from  .'.w  int.  rnal  luml,...  ..s|,d  an  h  .wA  also  fr..m  tlu-  tiatisv.is,. 
pr....'ss,,nd  lal.ral  margin. illlu  body  uf  tlu  m-t  lumbar  v.  rl.bia.  (  mlv  a  f,  w  lilufs  ari-.' Ir..m 
the  .Mernal  lumb...  ..st.d  ar.  h  an.l  this.-  m,,)  \»-  .  lUirely  abs.  1,1 ;  lli.v  r.  pr.s.  nt  the  c.mi.-.ti.m 
Utu.rn  th.-  lumlur  and  the  ...si.tl  porti.ms  of  the  diaphragm.  Tlu  las.  i.  uli  .■!  ilu-  .nit.  r  .  rnra 
an-  .orisl,K  i.iblv  -li,.rl.r  lli.m  iho..  of  llu-  inner  aii'l  mi.!. 11.-  on.-s. 

111.   ,.(//)-.(/  I,iui,>ii  li-iu.  .'s-M  i-  a  librous  lay.r  vvlii.h  inav  be  .illi.  r  n  nif..rm  .'r  sh.ip.d  lik.- 

a  ,|o\,r  l,al*an.lit-faMi,uli  uml.rg..  manifol.l  .1.-.  iissati.ms,     Tlu  .  ..nv.  \  siirfa.  .-of  llu-  ..ntial 

.,.n,|,,n  i-  -itu,!!.-.!  ani.-riorlv;   th.   molt-  nuirk.il  ..m.avitv  i-  ■  •  .  .•(!  posteri.irlv .      In  it  llu  n-  mav 

Ik-  i,...gni/.e.l  a  mi.l.'le  almost  plane  or  but  sii..hil\  <urved  port    .n,  whi.h  issitu.iU.I  b.Uv.en  tlu 

♦  llu  iluMt  li.ll  (.Till  i>  jiri-Miil  wh.  11  the  ti-nlriil  t.-n.l.m  i-.\l.  nL-.  li.w.ir.l  lli.  M.  01, il  (...lUuii 


1 


If't 

iti' 


w 


m^ 


l55  ATLAS   AND   TEXT-BOOK   OF    HUMAN    ANATOMY. 

ivvo  domes  of  the  diaphragm,  and  two  Icatlcts  which  are  directed  posteriorly.  The  left  leaflet  is 
the  smaller  and  forms  the  left  dome  of  the  diai)hragm;  the  right  is  larger  and  forms  the  right 
dome.  \\.  the  base  of  the  right  leallet  near  its  iK)sterior  margin  is  situated  a  large  irregular 
rounded  opening,  completely  within  the  central  tendon,  which  gius  passage  to  the  inferior  vena 
ca-c.  and  is  designated  the  opniiiii;  jor  the  vcm  cava  (qiiadrilaleral  joramcii). 

The  curvature  of  the  (liai)hragm  is  not  uniform,  but  there  is  a  middle  lower  portion  and  two 
lateral  domes  which  project  mar!;edly  toward  the  thoracic  cavity.  The  right  dome  is  more  capa- 
cious and  exten.ls  to  a  hi-her  level  than  the  left;  its  highest  point  corresponds  to  the  fourth,  that 
of  the  left  to  the  fifth  intercostal  si.ace.  I'osleriorly  the  dia].hragm  ( the  lumbar  portion)  extends 
much  lower  than  it  iloes  anteriorly.      Its  transverse   is  considerably  larger  than    its   .sagittal 

diameter.  ...  r 

The  diai)hragm  po.sses.ses  a  series  of  foramina  and  spaces  which  give  passage  to  vessels  or 
nerves  These  are:  ( : )  The  aortic  Ppcnhif;,  which  is  only  partly  formed  by  the  diaphragm:  (2) 
the  csophasealopciH,^,  purelv  muscular  and  formed  entirely  by  th.^  (liaj.hragm:  ^^)  the  opening 
jor  the  vena  cava,  situated  entirely  within  the  ten.iinous  j.ortion  of  the  muscle;  and  (4)  the  slit  like 
.paces  Ix'tween  the  inner  and  mi.ldle  crura  and  between  the  mi.l.Ue  and  external  crura.  1  he 
later  spaces  give  passage  to  the  vena  a/vgos,  to  the  vena  hemiazygos,  and  to  the  sympa- 
thetic antl  the  splanchnic  nerves,  whic>-  an'  arrange<l  in  a  variable  manner.  In  addition  to  the 
aorta,  the  aortic  opening  also  transmits  the  thoracic  duct. 

Thimui,.rmT^.of  Ih,  .li,i|.hr,,Kn,  i~lh,-,,hr,ni,  niru   fr.m.  lli.'..rvkal,,lcxus.  ,    ,       ,■     . 

...  drawn  .loLw.nl  an.l  ,1,.  .os.al  ,H,r,i.,ns  ar.  ,lrawn  away  fn.n  .nn.a,,  wi,h  <lu.  ,l,..ra,  i.    wall.  s„  that  .h.- thoracc 
lavilvi-iiniTiaM.l  in  >i.;i'iin'llhial«lMmiiial  lavilyisdiminisliid. 

"(Tlu-  .liai.hrasn,.  from  ll„-  .Irv.  l„;mH.nlal  s.an.l,».inl,  LdonRS  to  tho  ..rvi,  ,,1  n>UM  ulatur.-.  th,-  m..^,  lUar  t.ssuf  whuh 
i.  .on.ain.  l..inK  .hriv,-.!  from  th.  fot.rth  (an.l  to  a  ..rtain  .  xt.nt  from  tlu-  third  an.l  CfthU  .-ni,  al  nnotonus,   th,- .-nfr.- 

:,ru.,un-  Ivin^  at  „„.■  ,..ri.«l  of  ,1 ,.v..l,.pn,..nt  in  th..  .r.vi.al  r.-gi.m  an-l  lat.T  nd^ratin^  .l..wnwar.l  ,..  ..s  final  ,«...- 

,Ln  U  ,w,-,  „  th.  thora.  an.!  „b.l..m.n.      Il.n. ,-  it  is  th,„  it  is  suppli.-i  U  th.-  phr.-ni.  nom-,  wht.h  ar,s.s  from  th..  fourth 
ilhir.l  to  fif.hl  . .  rv  i.  .,1  n.rv...  an.l  .lon^at-  m  |,roi»,r.,on  a,  th.'  .li,.|.hr..Km  r.ced.s  t.,war.l  its  final  ,K.s,t,.  n.  --Kl.  ] 


THE  THORAQC  MUSCLES. 

The  muM  1.  >  of  the  thorax  i  Figs.  ,  ^-^,  247.  25,,,  an.l  2Mt  '>r''  cmposed  of  two  main  groups: 
, , )  Those  whi.  h  arise  Ifoin  ihc  th.-ra.  i.  skeleton  and  insert  ^  m.  llie  skeleton  of  the  up].er  extrem 
itv;   tlu  M-  are,  ,unse.|Uently.  -eally  muscles  of  the  extremity  .   and  ..^1  the  a.tual  muscles  of  the 
thoracic  wall,  whiih  are  known  a-  llie  intercostales. 

Th,-  first  group  i>  arran-ed  in  lime  layers  vhi.  h  are  not  exa.tiv  superimp.oe.l.  The  lirst 
hiyer  is  formetl  by  the  pr.tnrali^  major,  the  second  bv  the  pdoralis  minor  and  the  suhclavius,  and 
the  thinl  by  the  scrraliis  aiUrrior. 

THE  THORAaC  MUSCLES  OF  THE  UPPER  EXTREMITY. 
The  Firit  Layer.     The  Pectorahs  Major. 
The  pectoralis  major  .  Fig.  24s'  '>  a  large.  Hat,  thi.  k  must  le  whi.  h  is  situated  in  th.  sternal, 
inlrulaviMiln.  m.immary.  axillarv.  and  inframammarv'  regions,  its  out  r  iH.nler  forming  the 


THK   THORACIC   MUSCLES. 


■  67 


anterior  boundary  of  the  axilla.     The  muscle  is  ai)i)roximately  triangular  in  shai)e,  since  its  orisin 
is  very  extensive  and  its  insertion  ([uile  limited. 

It  arises  by  three  more  or  less  separated  portions,  which  are  designated  as  ihe  tlnvkular,  the 
sternocostal,  and  the  abdomiml  portions.  The  clavicular  portion  comes  from  the  sternal  half  of 
the  clavicle,  the  sternocostal  portion  from  the  anterior  surface  of  the  manubrium  and  tlie  IxkIv  of 
the  sternum,  with  accessory  digitations  from  the  cartilages  of  the  second  to  the  >i\lh  or  seventh  rib, 
while  the  alxlominal  portion,  which  is  by  far  the  smallest  i)orticin  of  the  origin  of  the  muscle,  is 
a  tlat  bundle  which  is  attached  to  the  lower  margin  of  the  sternoiostal  portion  and  arises  by  an 
aponeurosis  from  the  anterior  layer  of  the  sluath  of  the  rectus  alxlominis. 

Toward  its  insertion,  the  ])ectoralis  major  becomes  consideral)ly  narrower  but  corresjiond- 
inglv  thicker.  Only  the  filxTS  of  the  chivicular  piortion  and  the  upper  libers  of  the  -termuo-ial 
portion  jtursue  their  original  course,  the  greater  number  of  the  lil)ers  of  the  >terno(()stal  and 
alxtominal  ])orlions  ;)assing  from  the  anterior  surface  of  the  muscle  toward  the  posterior  surface 
of  the  tendon  of  insertion,  m)  that  an  extensive  twisting  of  'he  muscular  fasciculi  occurs  in  the 
outer  ;)()rtion  of  ilie  muscle. 

The  .endon  is  inserted  (Fig.  2()()l  into  the  entire  lengtli  of  the  greater  tubepular  (anterior 
bicipital)  ridge  of  the  humerus.  It  (onsists  of  a  weaker  jMisterior  a])oneurolic  layer  and  of  a 
stronger  anterior  layer  which  becomes  tendinous  inmiedialely  Ix'fore  its  actual  insertion,  iiolh 
layers  are  adherent  Ix'low;  the  anterior  is  formed  by  the  davicular  and  by  the  ujjper  part  of  the 
sternocostal  jjortion,  the  lower  by  tlu  bulk  of  the  sternocostal  and  alxlominal  portions. 

Tendinous  fasciculi  from  the  insertion  of  the  pectorali>  major  not  infn'(|Uently  bridge  over 
the  intertubercular  (bicipital)  gr(K)\f  and  jiass  to  the  latis^imu-.  Thoe  tiber>  s'lmetinus  contain 
muscle  fibers    the  miisdr  oj  iMiii^cr). 

The  two  i)eclorales  arise  from  llie  anterior  >urface  of  the  sternum  in  -ui  h  a  way  that  an  area 
is  left  in  the  middle  of  the  Umv,  narrow  above  and  somewhat  broader  below,  wiiicli  tontaiiis  no 
muscular  tissue  and  in  which  is  exposed  tile  sternal  meml)rane.  In  thi>  situation  the  sternal 
headof  thesleriKHleidoniastoid  (  Kig.  :?55)  (seepage  171)  1  Herders  inimeiliateiy  upon  the  pectoraiiv. 
and  at  the  daviile  the  origin  of  the  pectoralis  is  situate. i  exailly  opposiii-  to  the  davicular  head 
of  the  sternocleidomastoid.  The  anterior  margin  o'"  iheddidid  usually  l)()nlirs  immediatdv  upon 
the  U])i)er  convex  margin  of  the  ])ecliirali-- maje, ,  ;i  cDiisiderabie  s|ia(f  lietween  ihi  two  nnis<  its, 
known  at  llie  ddtoidiOpalonil  Iriaiit^li ,  usually  existing  only  inunidi^ili  i\  l)i  low  the  <  la\  i(  le,  and 
the  npliali(  vein  1  Fiir.  ii)i>  usually  runs  in  the  groo\c  between  the  two  miisi  Ks.  At  its  lower 
margin  the  pettoralis  major  is  (onlinuous  with  the  aponeurosis  oi  the  .il.iominal  muscles  dlu' 
sheath  of  the  redusi,  ;rid  itsouter  margin  bordiTs  anteriorly  iijion  tla  oblii|ims  MlMJoniinis  e\ter 
nus  and  ])osleriorly  upon  dli' serratus  anterior.  Tlutendolio'  'Msertiou  is  situated  between  the 
deltoid  U|)on  one  side  and  the  short  hi  id  of  the  binjis  ,md  tlu  ,  nrai  obrat  hinlis  ujion  the  other, 
in  this  situation  it  is  si])arated  from  the  l.itissiiuus  by  the  inierluben  ular  'biupii.di  groove. 

An  I mhiUiikU  iiu ml  imisi  li .  ihi   W/um/m,  i,  i|iiiii' r.m  Is  luiinil  u|iim  ihi   |in  Inr.iii- iii,ii">       ll  ni.iy  l«   I'M-rnl 

ii|Kiii  niir  iir  Imtli  .si(U>.  i-  i  lonKulrd,  tiiulinuus  ,ii  ii~  i  \lrrmitii  ~.  ,inc|  is  u-.u.illy  i  ■mim  Uc|  \miIi  Ihr  1.  inlmi  n(  ih.    -irrii.i 

I  |i'|ilMni:|.^'..{i|  :im!  (Iir  «lli;lth  nt  I  111;  n  rlll«  :li  well  .,»  uilll  I  hi    In  i  Ir.r.lli^  ni.liiir    .Uul  ll->ll.lllv  niili  srlMs  .1  |||-I|>I  .llcll  jKirtllin 

lit  llir  laUir  miisilc. 

'Ihr  |H(  tiiralis  iPiijiir  is  supiilinl  liv  llir  aiiti  rior  iIkt.k  It  ihtm  -  'I'lim  ihrr  «iih  lln-  l.ilissiiiiu»,  il  .uliiii.  N  llu-  .inn, 
nnil  "hen  it  ails  .ili.pr.  ll  ilra"s  ihc  arm  anii  ticirlv  iiinl  tun.ml  I  Iir  i  lirsi  ami.  al  llir  sanir  liiiu  .  r..|.iti  -  il  inlriii,i!l\ 


m 


I  :  -!■■ 

i  Is  !•  i 


It 


i68 


ATLAS    AND   TEXT-BOOK    OF    HUMAX    ANATOMY. 


The  Second  Layer.  The  Pectoralis  Minor  and  the  Subclavios. 
Tlu'  pectoralis  minor  (FIk-  24O  is  a  flat  trianjiular  muscle  which  is  comi.lclcly  concealed 
bv  the  i-ectoraHs  major  and,  at  its  insertion,  also  by  tlu-  <leltoi<l.  It  arises  by  thin  tendmous  slips, 
fr'eciuentlv  indistinctly  separated,  from  the  costochondral  articulations  of  the  seconrl  or  third  to 
the  fifth  nl)s;  it  passes  upwanl  and  outward  and  becomes  markedly  narrower  toward  its  sh..rt 
tendinous  insertion  into  the  ti|)  of  the  coracoid  i)rocess. 

It  coxers  the  upjier  portion  of  the  serratus  anterior  and  brid-es  over  the  axillary  vessels  and 
the  brachial  jilexus. 

-n,..  ,H-..orali,  ,nin„r.  lik.  llu-  major,  i.  .u,,|.li.  .1  l.y  .hr  anfrior  ,l,„ra,  i,  n,rv, ,.  I.  .lra«.  ,1„«„  ,lu.  s,  apula,  „r. 
if  llu-  Maimla  1..-  Mm.!   ■.  i.vaK  ■;  the  rih~,  an.l  il  .  an  al>o  ai.l  in  tixiiiK  tlu-  siajmla. 

The  subclavius  (Fi-s.  24;  and  26.,)  i>  a  small,  elongated,  somewhat  flattened  muscle  whi,  li 
■irises  bv  a  ten.lon  from  the  first  costal  (artila-e  alongside  of  the  costoclavicular  ligament,  and  is 
'insene.1  into  ih.-  umier  surfa.e  of  the'  acromial  end  of  the  .lavicie  iK'tween  the  two  portions  ol 
Ihe  c.racociaxicular  ligament  (see  page  .20..  In  this  situation  there  is  usually  a  shallow  groove 
in  the  iMine. 

Tlu  nerve  ^ui.i.lviMKlh.nu ■  i.  ilir  Mil.,  lavian  from  llu-  l.ra,  hial  i-l.-xus.  .    „    ■    ,-      , 

Th,.  L..  ].■.  l.y  ii.  ,  ontra,  uon,  tiw,  th.- ,  lavi.  l.  in  ihc  M.-rno.  iavi,  uiar  join,,  an,l  when  .h,-  .howM.r  «,r.ll..  ,-  U..i 
the  iTUi-ili-  il.  vatf^  till  lir-i  ril.. 


•-''• 


The  Third  Layer.     The  Serratus  Anterior. 

The  serratus  anterior  isrmiius  „ur^ni,s,  (Fig^.  247.  -\soi  is  covere<l  in  its  uj.per  i^ortion 
bv  l..lh  pectoral  .hum  k-  i;>  lower  portion  i,  >iuiate.l  in  the  lateral  pectoral  region  an.l.  immedi- 
aielv  1k4ow  the  i.ectorali-  major,  i^  covere.l  only  by  the  inlegumint  and  tax  .a,  the  m.,M  mfenor 
poitiop  .,f  llu'  muM  K-.  howevn-.  being  pla.ed  beneath  the  anterior  margin  ol  the  lan»imus. 

Tlu'  nuiMle  i^  Hat  thnmghout.  irregularly  .|ua<lrilateral  in  shape,  an.l  its  muMIe  i.orlion  i< 
verv  liiin;  it  forms  a  muMular  plate  whirl,  i-  adapt.<l  to  tlv  -urvetl  surface  of  the  thorax.  It 
ari'r.  from  the  lifM  to  the  ninth  ril-  bv  mean,  of  individual  serralion>,  the  lower  live  ol  which 
are  di-liiu-iv  M-aratid  and  inlerdiuitale  with  the  serrations  of  the  origin  of  the  obliMUUs  exter- 
num alHloniiiiis.  In  tin-  bp>,,,l  mu>.  le  sluet  formed  h^  ihe  uninn  t.f  the  >errations,  three  pt.r- 
tions  disiin.tiv  din.t-en'.iated  bv  thr  .linvlioi.  of  their  libers,  may  be  recognized.  'Ihe  libers 
,,f  the  upiKT  and  Inv.rr  pnrliuns  eonverg.-  mward  tln^  inMTlion  of  the  nuiMle.  while  those  ol  the 
middle  seumuin  i.a^s  in  tlu  s:,n,r  .liivcli.-n  bal  in  a  diveiging  manmr.  Thr  noper  ■  onvergmg 
,,,,riion  ,Fig.  2-,S,  ariM-s  as  a  rather  strung  inuseular  mas,  trum  the  lirst  an<l  McomI  ribs  an.l 
fr.m  aninlrrvt-ningl.iidinousarch;  it  ins,  Hs  into  the  superi..r  angle  of  tin-  >capula:  the  mul.lle 
.!ix,T..ingi.<,rti,.n  is  bv  far  the  thinm-st  and  Nv,-akesi  part  of  ilu'  mus.K-  an.l  it  aris,>  fr.^m  the 
,,-,  on.l  *  .1,1,1  Ihinl  :il)s  and  .liv.rg,  s  marke.liy  to  b,-  inserl.d  in-.,  ih-'  .ntire  l.-ngth  ol  the  vertebral 
iH.nl.r  of  thes.ai,ula;  an.l  the  lov.er  cnvenging  porti.,,,.  which  is  du- slron.gest  part  ..ftlie  enllfe 
muMle.  arises  from  tin-  fifth  t.-lh,'  ninth  ribs  ami  i,ass,s  1,,  tlie  inh-n.,r  au'^de  .,1  tin  m  apnia.  1  !,.• 
fibers  „f  tin  L.wer  p.>rti.,n  aiv  il„-  h.ngest  an.l  those  ol  tile  upjier  porli.,n  ,,iv  ihe  short,  si.      1  he 


*  I'),,'  s,  ,..n<l  1,1.  ,o„-ci|i,.„,;.     iM  -  o:iiiin  ,0  ,wo  SI  I, a,  10,,.., 


THE   THORACIC   MUSCI.KS. 


160 


muscle  is  tlcshy  ihrouRhout,  ^vilh  the  exception  of  the  insertion  of  the  mid.lle  portion,  ultieh  is 

Mimetimes  ;i|)oneurotic.  .  , 

In  order  to  reach  the  vertebral  border  uf  the  scapula,  the  serratus  antenor  must  ,.ass  back- 
^vard  for  quite  a  distance  alon,  the  thoracic  wall,  to  which  i,  is  attached  by  oose  connective 
tissue  When  the  muscle  reaches  the  axillary  border  of  tlte  xaptda  >t  passes  belund  the  sub- 
scapularis  as  far  as  the  vertebral  border  of  the  bone  and  is  separated  front  th.s  muscle  by  a  xery 
l(H,se   onneclive  tissue.     Throughout  its  course  it  fornix  the  mner  Nvall  of  tlie  axtUa. 

ihoMTrat,Ham.-riurHsiii,,,lhcll,vthrlonKtli"r:,,i,  mrvofromth.-l,r.,hi.,l|.U'vu, 

::t=i::i;';;;:r;:;:;i::;r";;r;;.;r«=t;r::;,:  :f  t:  -     .;...„ 

levat„r  s.apuk-V  tlu-  serratus  .an  al.,  .Uval,-  tlu-  rih.  an,l  a,  t  a.  an  accessory  nni>,  Ic  ,.[  rc~,„ra.>..n. 

THE  MUSCLES  OF  THE  THORAaC  WALLS. 

The  muscles  of  the  thoracic  walls  are  the  iutmoslalcs,  tlte  IruUons  cosUnun,.  the  suhroslah's, 

and  the  Iraiisvirsus  Ihormis. 

The  intercostales  (Figs.  247,  250,  25;,.  an<l  251)  occupy  the  eleven  uUercostal  spaces  and  are 
.omposed  of  two  lavers,  an  external,  the  iuUra.sluIrs  c.v/cr;,/,  and  an  intcTnai,  the  n,l<rrosl.,l,s 
nU,nu.  The  h.lrnoslalcs  cxUrui  (Figs.  24..  2  ,7,  250,  an.l  254)  pa-  fron,  above  downward  and 
from  witiiout  inward  l>etween  the  bonlersof  adjacent  ribs;  they  are  ^hort  Hat  nmscles  winch  fre- 
nuentlv  contain  numerous  tcndin.ms  tiberx  They  commence  posteri-  iv  in  the  region  ot  the  costal 
tulx'rcles  and  ex  end  ant.riorlv  as  far  a^  the  ci.sto.  hondral  articulations,  leavmg  the  spacrs 
Ix.tween  the  co>tal  cartilages  free.  In  these  spaces  a,v  found  tendincn^s  slips  «h.ch  run  m  ttf 
same  clinrtion  as  tlte  liber>  of  tlu'  intercostales  c  xterni  and  extend  to  the'  margnt  ol  thc^  Mc  rmmt; 
Ihev  are  called  the  r.\l,riuil  inknn'-lcl  li-oimnls  di^nmnUa  n>rus,  ,iiUi,i). 

■  The  inlrnosl„lrs  ;»/,r»/  ( Fi->.  2^0,  25;,,  254I  run  from  alxnv  downward  and  from  wuhin  out 
xvard  between  the  l..rder.  of  adjacent  rib>,  and  they  ari.e  fron,  ihc^  lower  l..rd>  r  ol  llu.  upper  r,b 
c.f  each  intercostal  ^pacr  in  -uch  a  manner  that  the  co-tai  groove,  i.  .i.ualed  belwe.'n  the  two 
muscular  lavers.  Thev  cross  ,he  intercostales  extern!  at  right  angles  an-l  arc  c-ov.T.-d  by  ih.^m 
cxeept  in  the  spaces  b,iw.en  the'  costal  cartilages.  They  .  xtc^nd  ante  riorlv  lo  \\n-  sic  rmmi  or  to 
,!,,  anterior  exlrendli.  s  of  the  crlilages  of  the  f.dse-  ribs  and  end  posh  riorlv  a.  .I,e  costal  angles. 
|„  ,1,,  n.'ion  of  the  costal  cartilages  thev  lie  behi.ul  the.  external  intercc.slal  hgananls  and  those 
ncrtions  of  then  occ  urring  in  these  situations  atv  also  terntecl  the  in>,rn,rlihK<'»n.  He  Iw.c  .,  the- 
posterior  ex.rcntities  of  the  ribs  t!tey  arc    replaced  by  tendi.x.us  structures  win.  h  are.  called  the. 

iiilirihil  iiihirv^hil  lii'jiiih  »/..■. 

•i'h,.  inlrnosl.il.^  rxl.nr  are  covered  almosl  throughout  their  entire.  exU'iil  by  the-  ihorac  ir  . 
•dnlonunal  an.l  -lorsal  mu^  .pectoralis  maje.r  an-l  minor,  serratus  anterior,  obliquus  alHlonunis 
externus,  I'alissimus,  s,  'i  ,,.,slc.riorcs,  rhomUmieii.  uilh  the  excepti.  -  e.t  a  sn,all  area  U.lue..n 
the  irape/.iiis  and  tlie  l.ii.ssimus  i|.'ig.  2^S).  ^  ^ 

The  levatores  COStarum  iFig.  :\:.>.  in>ni  cite  coiose  e,f  iheir  ii'ncr.,  ':ele;ng  U-  t.ie  (•-!!  ;-';a, 
inte-rc  u  .tal  nuisclcs.  Thev  ar,.  siluatc-.l  :n  th.'  dorsal  thorac  ic  region  imme.liai.iy  beside  the  deeper 
h.vers  of  the  long  muscles  of  the  back,  a.e  covered  by  the  sucrospinalis  (particularly  by  the 


V:tl 


!'     ff 


i 

II 


J  i 


t    V 


170 


ATLAS    AND   TEXT-BOOK    OF   HUMAN   ANATOMY. 


Fig.  253.— The  sternum,  sternal  ends  of  the  clavicles  and   the  rihs,   with  the  intercostales,  and  the 

transversus  thoracis,  seen  from  behind. 
Fig.  254.— The  fifth  to  the  twelfth  thoracic  vertebnu  and  the  vertebral  extremities  of  the  corres|)onding 

ribs,  with  the  intercostales  and  subcostales,  seen  from  in  front. 
On  the  left  silk-  the  intercostal  ligaments  have  tx-en  remuved. 


iliocostali.s),  and  are  <li\  idcd  into  tlie  In-alores  costariim  brnrs  and  lon^i.  The  Icvatorcs  costarum 
breves  iVvT,.  24?)  arise  from  the  transverse  jjrocesses  of  the  seventh  cervical  to  the  eleventh  thoracic 
vertebric  and  insert  into  the  rib  next  below  between  the  tubercle  and  the  angle.  The  Inuilorrs 
costarum  longi  (Fig.  243)  are  found  chietly  on  the  lower  ribs  and  are  distinguished  from  the 
breves  in  that  they  pass  over  one  rib  and  in.serl  into  the  second  below  near  its  costal  angle.  The 
levatores  costarum  become  markedly  broader  toward  their  insertion  and  usually  jjossess  aponeu- 
roses. 

The  subcostales  (Fig.  254)  are  flat  muscles  which  are  not  always  present  and  vary  greatly 
in  their  develojjment.  PVoni  the  direction  of  their  fibers  they  are  to  be  grouped  with  '.he  internal 
intercostal  muscles,  with  the  ])oslerior  portion  of  which  they  are  continuous.  'I'hey  are  found 
chietly  in  the  lower  ihorai  ic  region  and  bridge  over  one  or  two  ribs.  Thev  are  usually  i)artly 
tendinous  Ijoth  at  their  origin  and  at  their  in.serti(m. 

The  transversus  thoracis  {trianguhiris  slcnii)  (Fig.  25,^)  is  a  very  thin  Hat  muscle,  the 
greater  ])ortion  of  whidi  is  tendinous,  which  arises  by  a  broad  aponeurosis  from  the  posterior 
surfaces  of  the  Ixnly  and  xiphoid  jtrocess  of  the  sternum  and  inserts  by  short  broad  tendinous 
slips  into  the  inner  surfaces  of  the  cartilages  of  the  second  or  third  to  the  sixth  ribs.  The  muscle 
is  constant  but  very  \arial)le  in  its  development. 

All  ihe  niusiles  of  ihe  ititireostal  siries  are  supplieil  tiy  the  iiiten  o...tal  nerved  «hiih  pa^-.,  ioj;ith<r  with  the  vasa 
intereostalia,  between  the  intiTnal  and  the  external  inleuostal  nuiM  le-. 

The  intereostal  musi  lesare  im|Mirtanl  must  les  of  respiration.  The  great  majoril)  .if  iheni  ,ire  niiisi  lis  of  inspiration, 
hut  the  transversus  thoraiis  and  the  subcostales  probalily  play  .some  part  in  e.\piralion. 


THE  PECTORAL  FASQA. 

The  fxrlonil  jasrin  lies  upon  the  |)eci(iralis  major  and  the  lower  ])orlion  of  the  scrralus  ante- 
rior. The  toraiiHlavuuliir  jtisda  iroslocoraco/i/  ninnhninc}  is  a  mucii  more  iironouncfd  lavcr  which 
is  situated  Ix-nealii  tiie  jiectoralis  major  and  upon  ihe  ])ee  toralis  minor,  covering  the  stibdavius 
and  the  axillary  vessels.  It  is  particularlv  firm  where  it  lies  upon  the  subc  la\  ius  and  inserts  into 
the  lower  surface  of  tiie  i  lavidc.  Inlernally  it  is  in.sertcd  into  the  u|)per  costal  cartilages;  exter- 
nally it  is  continuous  with  the  axillary  fascia. 

[  \s  was  111.-  I  ase  in  the  dorsal  ri'Kion,  all  the  nui.si  ies  referred  to  the  horaiie  region  in  the  aliove  deseription  do 
not  striitly  iH-lont;  to  the  lliorai  ii  nuisuiiature,  but  Ulon).'  in  part  to  the  niu.si  ulalure  of  the  ujiper  extreiuiiv.  This  is 
true  with  reRard  to  the  mu.sc  les  of  the  lirst  three  layers,  only  those  desi  riln-ii  as  the-  muse  les  of  the  thorai  ii  walls  l-einn 
trunk  musi  lis. 

These  may  lie  i  lassHied  similarly  to  llie  alidonunal  nni^i  ii  s,  but  oulng  to  the  presenie  of  .1  stirnuin  in  ihe  ihorai  ie 
region  and  to  the  lesseneil  mobility  of  the  ihorai  ii  |Kirtion  of  the  spinal  luhitnii  due  to  the  pre.senie  of  fullv  di-veloped 
ril»,  no  representatives  of  either  the  riitusor  hy|K>skeletal  gri  aps  ckc  ur  in  this  region.  The  ilassititalion  is  1  onsi'C|Uently 
as  fuhows: 


M'm 


in 


i  t ' 


in.  I 


I 


M^mmmmsmii^: 


THE   MUSCLES   OF  THE   NECK. 


171 


Hyposkrlctal :  wantir.f;; 
Rectus:   wanting; 

Oblique-  Inlrnoshilesexlerni,  intccoslaks  bilcrni,  uiWosUile^.  /r,ji.urrji,<  Ihoracis,  and  lcv,Wm-.  ,ml,trii»,. 
In  a.l.liti.,.,,  two  muscles  descrilH-l  as  t,el«nKinK  to  the  muscles  of  the  hack  are  prohahlv  numl.ers  of  the  thorauc 
ol)lii|ue  Kroup,  namely,  the  sirralus  fmslerior  supcrwr  ami  the  serralus  posterior  injcrtor  — I'.D.] 


THE  MUSCLES  OF  THE  NECK. 

The  muscles  of  the  neck  (Figs.  256  to  259  an.l  2(.7i  incKulc  the  i.latysnip,  the  sternocleido- 
mastoi.i,  the  hvoid  muscles,  and  the  deep  cervical  muscles.  The  hyoi.l  muscles  are  sulKJivided 
into  the  suprahyoid  and  the  infrahyoid  ^roap;  the  dee])  cervical  muse  U  >  are  comi)osed  of  an  outer 
group,  the  scaleni,  and  of  an  inner  grou]),  the  ]>revertehral  muscles. 

The  platysma  im.  suhniUimus  colli)  (Figs.  260  and  20; )  is  a  thin,  tlat,  (luadrilaleral  muscle 
which  is  situated  in  the  sulxutaneous  connective  tissue  in  the  neck,  the  upper  portion  of  the  chest 
and  the  lower  j.ortif.n  of  the  face.  It  arises  (Fig.  207)  from  the  fascia  over  the  pectoralis  major 
and  the  deltoid  at  the  level  of  the  first  or  second  rib,  by  sej)arate  fast  iculi  which  are  fre<iuently 
separated  bv  interspaces.  .\t  the  level  of  the  clavicle  these  fasciculi  unite  to  form  a  broad,  thin, 
compact  muscular  layer,  which  leaves  uncovered  tlie  anterior  cervical  region  but  covers  more  or 
k>s  extensively  the  lateral  cervical,  the  sternocleidomastoid,  the  carotid,  and  submaxillary 
regions,  and  toward  the  chin  the  margins  of  the  two  muscles  convi r-e  and  m.  >  1  cacli  other  in  the 
mental  region,  freciuently  interlacing. 

Some  of  the  fibers  of  the  platysma  are  attached  to  the  lower  i)order  of  the  mandiltle.  while 
the  rest  pass  over  the  mandible  ami  ai)i)ear  u-pon  the  face,  graflually  disai)pearing  i)aitly  upon  the 
par  )tideo- masseteric  fascia,  and  parllv  by  intermingling  with  the  risorius  and  triangularis  by 
wnich  they  reach  the  angle  of  the  mouth. 

The  [ilatvsma  is  .ufphe-l  I'v  the  c<T\ical  branch  of  the  fa.  ial  nerve.  1>  ^^rinkl.s  the  skin  i.^  ih,-  cervi,  a!  and  upper 
thoracic  regions  and  ...  Is  upon  the  angle  of  the  mouth  with  the  facial  nmsi  k  s.  H  .  an  also  i,»  re.ise  th.  u  nsion  of  ih.- 
fasi  ia  iir  the  fai  ial,  cervi.  .il,  an.l  th.ira.i.   ri'gi.ms. 

The  sternocleidomastoideus  (Figs.  2;,S,  25;,  256,  260,  and  2(121  is  a  strong,  broad,  and 
thick  muscle  which  is  situated  in  the  sternocleidnmastoid  region.  It  arixs  Ir.  two  heads,  a 
strong,  thick,  tendinou.s,  sternal  head  from  tlie  anterior  surfaie  of  the  manubrium,  and  a  -hort, 
tendinous,  clavicular  head  fr.im  the  sternal  end  of  liu-  tlavicle. 

The  sternal  head  |)asses  over  the  sternoclavicular  arliculalion  and  forms  a  muscular  inter- 
space of  varving  si/e,  the  Ir.ssrr  sii pnuhivkular  jnssd,  by  uniting  with  the  clavicular  licid.  It 
becomes  much  wider  as  it  iiasses  ujiwanl  to  a»i-t  in  fnrming  the  tiiick  belly  ol  the  nniscle  and 
]iartly  conceals  l!ie  (la\icular  portion. 

The  sternoclei.i.. mastoid  is  inserted  into  the  outer  surlaie  of  the  mastoid  process  of  the  tern 
]>oral  bone  and  into  the  outer  half  of  the  superior  nuchal  line ,  the  anterior  [Kirtion  of  the  insertion 
being  c  tlected  by  a  sh.irt,  the  jiosierior  iioriie:,  by  a  long  leiuion. 

The  musck  passes  obli(|uely  throug  me  neck  from  below  upward  and  from  within  outward. 
At  its  insertion  it  borders  upon  the  trapezius  (see  page  145)>  with  the  anterior  margin  of  which 


V    t 


172  ATI  A';    ANr>    T1..XT-1    .OK    OF   HUMAN   ANATOMY. 

Fig.  255.— Sufc  rficial  i .   <  r  <  f  the  musde>  of  the  neck,  seen  from  in  front. 
On  Ihi-  riKht  si.ii-  ihe  stc-r-.uhyoid-  n-i     •  .i  .    1  x  <)/  tH.  iliKiiMri. ,  and  llir  -submaxillary  glan.l  hav.   ln'cn  nmovid. 

Fig.  25().— Superficial  layer  m  ihe  muscles  of  the  nc(  k,  seen  from  the  left  side. 
*  =■  Kxtcrnal  carotid  artiry. 


it  forms  a  irianijle  in  which  arc  siluaud  die  splenitis  capitis,  the  levator  scapiiLc,  the  scaleni, 
and  the  inferior  belly  of  the  uniohyoi.i.  The  anterior  man.,'in  of  the  mu.sclc  Ijorder-  ujio:  the 
infrahyoid  muscles,  Inninds  the  carotid  fossa  (a  deep  muscui  ir  inters _.ace  c  :itainin:.  the  '.<rnii 
vessels  of  the  neck,  /.  < .,  the  common  caroti.!  art.  ry  and  the  internal  jugular  .in,  and  the  xa.mi-. 
nerve),  and  crosses  over  and  cone  ■-  al~  the  pi-tcrior  bdlv  of  the  digastric  and  stylohyoid.  The 
ujjper  part  of  its  anterior  margin  is  a!.o  in  relation  with  ihe  paroud  gland. 

Th.-  sl,rnocl(ii!nni;i5l.iiil  i'>K'  'her  Ai'.h  Iho  trapezius  i.^  supplii-il  liy  t!'-  ain-ssory  n.  rv,. 

When  lK>tli  slirn(Kk'i.lnmasti)ids  ait  tonith.r,  Ih.  y  <lraw  thi'  li.-ad  li  ^wnwanl  an.)  i..rK,,r  i,    ulu-n  ..-u-  niu*.:.  a<t~ 
alum-,  it  turns  tin-  luad  ohliqmly  so  that  the  f.uc  Kx^'k-  upward  aivi  mward  the  <)i.|.<.sin-  ^idc. 


THE  HYOID  MUSCXES. 
The  Infrahyoid  Muscles. 

The  infrahywid  muscles  (Figs.  2;:.  ;?,'''.  and  2^Si  are  situated  betv. 
the  upper  margin  nf  the  thorax,  chi(  :ly  in  the  anterior  cervical  region 
ation  of  the  rectu-  alxlomiiii-  ir.to  ihr  ne(  k,  being  the  remains  of  an 


Some 


!u'--e  nvu--. 


laver      liich  i-   !!iterru]ilrd  in  the  thoracic  n-gion. 

retained  indiiaiions     ^.  'heir  original  ^-gmental  tendinous  intersectiins. 


tin    ;;;  :ie  am) 

lepreseni       continu 
1  ,  11     >inglr  mu^-    lar 
lik>   the  rectus,  have 
The  group  till  ludes 


the  slirnoliv'iitltus,  the  ^Irr}^  •ihyr-o'uhii':.,  the  ihyn; 

The  stemohyoideus  Uig^-  -  - 1.  \v^>  -.'"•  •" 
which  i-  -imaled  in  th.    suprasternal,  lliyroid,  la- 
(I*'ig.  2;4l  from  the  iiil'.rnal  surfan   of  the  lirsl  co 
the  manubrium  ,.nd  llie  cai. stile  of  the  slernoclavi- 
bv  the  .sternal  end  of  t'  ■  i(  le  anil  the  stem 

ujiwanl  at  a  sliglr  distai  ■;!  Jl'c  median  lii 

into  tile   body  of  the  IumkI   bone.     It  not   in" 
inscription. 

The  sternothyreoideu     Fiu-.      ;,,  25-;, -'^o. 
origin  is  similar  iiit  n.ure  duply  :  l,i     d  iImi.'.  2- 
second  costal  cartilage.     T'  e  lov.,  r      ■rlioii  of  \; 
and  die  sleriKH  kidomastoi  i,  but       -- ■  '')'  tile  sti 
])roje(l  biyond  the  Litter  muscle,  an.    its  nii.ldlf  ai         w':- 
benea''!   the  ui'per  Ik  '  .   of  the  <  .nioh;,  "idelis.     ll      ir 
lil\reoiii   gi.imi,    |  las.si  -   .iniillV  U,..'.  aiM,    s,-.  \r,\\\   r.w.y  :: 

betAcen  tin  two  must  k  s  ,,f  opposite  ■ 'des,  ami  is  inset" 
canilage.  .i''>r  additioii  .1  details  -  "Si. he  hnologx 
must  ll  -  is  situated  a  tiorli'      of  the  lar\  n\,  ti       tiyreoidgla 


oidciis,  and  the  miioii 
'^.Si  i-  a  tlat,  long,  an. 
eal,  subiiyoid,  am; 
eartil;  ;e  and  froni 
;r  artii  n'  iiion,        ' 
of  lie  stern  -  ii 
,;!g  somcwhn    nar 
e.xh)i)i       a    fi-  '  "■■ 


r  n.!  niuscle 

■Su  in  ""{.ses 

III-  ol 

.ritiin 

.is.ses 

tied 

tendinous 


-onii 

.1U.S(  i 
■lV<il- 


lh:i  lyoid.      lis 

t;  (1.  .Is  I'ar  as  the 

on:  manvibriiim 

uier  .  aner  margins 

;  ■  rtioii  ..;e  also  situated 

miisi  le  which  covers  the 

■.    ]^■([    in    !h.-    !i!r.!l:o-    lini' 

;.li(iue  line  of  the  thyreoid 
ic    spai  e    between    the    two 
i,  ai      liie  irai  Ilea. 


iL 


f 

.a 
I 


■■■■ 


'  ■  V 


Hi 


THE  inJSCLES   OF  THE   NECK. 


173 


The  thyreohyoideus  (Figs.  255,  256,  and  258)  appears  to  be  a  .lireet  continuation  o  the 
sternothvreoid.  It  is  a  flat  musele,  the  greater  iK)rtion  of  which  is  concealed  by  the  upper  belly 
of  the  omohvoi.1,  an.l  it  passes  fn.m  the  oblic,ue  line  of  the  thyreoid  cartilage  to  the  hyo.d  Ixme, 
where  it  is  inserted  fei.le  the  sternohyoid  into  the  lateral  portion  of  the  U.dy  an.l  into  the  base- 
,.f  the  greater  cornu.  A  fasciculus  sometimes  passes  from  this  muscle  to  the  thyreoid  isthmus 
and  is  known  as  the  Innilor  f^latulidfc  lliyrcoidccr. 

The  omohyoideus  (Figs.  2vS,  256,  and  258)  is  a  long,  flat,  narrow  muscle  which   is  com 
posed  of  two  distinctly  separated  beUies.     The  injcrior  hdly  arises  from  the  upper  iH.nkr  of  the 


Utnii'li yngldss i  {il ivided) 


H'imtis  I'l  miiiiilihir 
isrf/i.'ii) 


drrtilir  ciirnu 
Vx,..   :!S7      Till-  Mivliihyni.l  ami  jjmiuhyi.iil  imiMk-.  .-i<n  ffmi  al".ve. 

scapula  iKtween  the  inner  angle  and  the  notch,  >ometimes  luing  alx.  attache.l  to  tlv  transvers. 
ligmient  It  i^  ai  first  cov.red  bv  the  tiape/iu^  an.l  tlu'  davi.  le  an.l  ihen  IxTomes  suimtIu  lal  m 
the  greater  supra,  lavi.ular  fossa  a>  it  passes  t..  the  po>tenor  margin  of  llu-  M.rnocl.  i<loma>to..l.  us 
Henealh  the  latter  it  f..rms  a  flat  interm..liate  tend..n  which  i^  a.ilierent  lo  the  cerM.al  fas.  la  an.l 
,„  the  sheath  of  the  great  vessels  of  the  neck.  The  sHf>rrior  brily  ...innun, .  s  at  ih.'  .nterme.liate 
ten.lon,  appears  at  the  anteri..r  margin  of  the  slerno.  lei.i.Mnast..i.l,  partly  ...n..ai.d  bv  ill.  M.rno 
lhyre..i.l  an.l  il,yre..hyoi<l,  an.l  is  inserte.l  imme.liately  alongsi.ie  ..f  the  slern..hy..Hl  int..  the 
j.^^.^,.  !^,r,!,..-  (.f  thi'  lateral  iwrtlon  of  the  hyoid  Ixme  in  front  .)f  the  thyri-ohyoid. 


•l-h-  m(.al.v..i.l  nu.„U-.  »r..  ,u,,l,li..l  fn-m  tli.-  u,.,"r  ..-rvi.al  nrrvr,  tl,r.m«h  .1,,    ..M..lk.l  nn>a  1.v,h,r 
thvr.-..lnoi,1  r.-,.iv.-.  a  .(.r.  ...1  t.ra.v  I.  Ir-m  (h.  -...»■  n.rvs,  «hi.  1.  a. .  ..n,|.anH  s  ihr  l,>l..«l."Hal. 


Ihr 


I' 


i   11 


174 


ATLAS    AND   TEXTBOOK    OF   HUMAN    ANATOMY. 


Fig.  258.— Deep  layer  of  the  muscles  of  the    rck,  seen  from  the  left  side. 
The  anterior  Ix'lly  of  the  iliRastric  [  the  niylohyoirl,  thi>  stcrnoclcidomastoiil,  ami  ilit-  sternal  end  of  the  clavicle  have 
been  removed. 

Fig.  259. — The  deep  mu'Jes  of  the  neck,  seen  from  in  front. 
On  the  ri^ht  side  the  longus  capitis  has  U-en  drawn  outward. 


The  infrahyoid  muscles  depress  the  hyoiil  Inmi ,  the  stemothvreoiil  draws  down  the  larynx,  and  the  thyreohyoid 
approximates  the  hvoid  Ume  to  -he  larynx.  They  also  act  a.s  ai  cessory  musi  l<-s  of  ilcKlutilion,  an<l,  hy  its  attachment  to 
the  sheath  of  the  great  vessc'ls,  the  omohyoiti  fai  ililates  the  return  of  blood  through  the  internal  jugular  vein. 


'.J»' 


i.ii. 


11 


The  Suprahyoid  Muscles. 

The  suprahyt>i(i  muscles  (Fij>s.  255  to  258)  lie  between  the  hyoid  bone  at-'i  'he  mandible. 
Thev  are  the  ili)^tislricus,  the  slyloliyoidfus,  the  myhhyouicus,  and  the  gciiialiyoiihus. 

The  digastricus  {bivcntcr  mandibula)  (Figs.  255,  25b,  and  258)  is  a  ty])i(al  two-lxllied 
muscle  wit'i  a  distinct  cylindrical  intermediate  tendon  which  is  attached  to  the  hyoid  Ixtne.  The 
two  bellies  form  an  obtuse  angle,  oi)cn  above,  in  which  is  situated  the  sui)maxillary  s;ilivary  };land. 
The  anterior  Ix-lly  is  a  fairly  thici.  muscle  which  pas.ses  from  the  intermediate  tendon,  frwiuently 
rec 'iv  inji  a  fi  w  tendinous  IiIkts  directly  from  the  hyoid  !)one,  to  the  diga.stric  fo.ssa  of  the  mandible, 
wheic  it  is  inserted  by  a  short  tendon.  The  ^fterior  htlly  is  longer  but  somewhat  weaker  than 
the  ai  terior  one.  It  arises  from  the  mastoid  notch  of  the  tcmi)<)ral  Ijone  and  passers  with  the 
stylohyoidiiis  to  the  hyoid  region,  where  it  iKfomes  continuous  with  the  intermediate  tendon. 

The  anterior  Ixlly  of  the  digastric  lies  in  the  submental  and  mental  regions,  Ix'twwn  the  skin 
and  the  mvlohvoid;  the  posterior  iK-lly  is  omjiletely  concealed  at  its  origin  by  the  stemcK  leido- 
mastoid,  and  further  anteriorly  it  seiuirates  the  submaxillary  region  from  the  carotid  fossa. 

When  iIk' hvoid  iH.nc  i..  fixed,  the  anti  nor  1.1  .'epn-s.M-»  the  l.iwcT  jaw  and  opens  the  mcvulh,  ih.  posterior  iM'lly 
draws  the  hvoid  l»ine  bai  kw.ird  anri  upward  and.  u. net  her  with  the  stylohyoiil  and  the  infrahyoiil  mus<  les.  fixes  the  hyoid 
Umr  The  |Histi  .-ior  In  llv  is  •  upplied  by  the  fa<  iai  nerve,  the  anterior  Ully  by  tin  niyjoliyoii!  nerve  twin  the  third  division 
ipf  thi'  trigeminus. 

The  stylohyoideus  iFigs.  2;^,  2;^,  atui  2;8)  arises  by  a  tendon  Irom  the  styloid  process  of 
the  temporal  Ixine  and  run^  ;i>  the  hyoicl  txiiie  as  a  tlai  rounded  muse  Ic-  aU)\f  and  almost  parallel 
to  the  posterior  Ik'IIv  of  the  digastric  before  its  insertion  into  tin  lioi-r  it  almost  always  divides 
into  two  slips,  iK-tween  which  ll;.'  intermediate  tendon  of  the  diga'^^lric  jiasses.  These  slips  have 
muscular  attachments  to  the  base  of  the  greater  cornu  and  ic  the  posterior  extremity  of  the  IhhIv 
of  the  hyoid  lK)ne. 

'lh<' ailion  ..f  iheniusileis  similar  to  that  of  the  |(osicrior  Ully  of  ihe  illgasln.  and  ii  e.  aKi.  supplied  by  the 
fa(  iai  nerve 

Hetweeti  llie  infrahvoid  musdc^  .ind  ilu-  anterior  Uirder  of  the  sterniM  leiiloinastoid  there  n  mains  a  <leep  »pai  e 
Niunden  above  bv  the  inwierior  IhIIv  of  the  cligastrii  us,  iliis  is  'lie  ,,in>liil  /m<.i.<,  und  il  i  ontains  the  ((real  vessels 
and  nerve  of  the  neck  (llie  i  oitimon  i  amlid  arlerv,  the  interna!  jugular  v.  in.  and  the   \agus  mrvel       The    lateral   wall 

Ihe  mylobyoideus  (Figs.  2^6  to  258  and  2f)?)  is  a  (ifculiar  broad,  llat  muscle  which  is 
situateii  in  the  submental  and  submaxillary  regions  .mil  is  partly  covi  red  oy  the  anterior  ImIIv  of 


i 


HI 


i'i 

n 


■    i 


It  ' 


'll 


.     *. 


H  f 


THE   MUSCLES   OF   THE   NECK. 


175 


the  digastric.  The  two  muscles  of  opposite  sides  unite  in  the  median  line  in  a  slightly  tendinous 
mvlohyoid  raphe,  and  form  a  muscular  layer  which  extends  across  the  mandibular  arch  and 
constitutes  the  floor  of  the  mouth. 

Each  muscle  arises  (Fig.  257)  hy  a  short  tendon  from  the  mylohyoid  line  of  the  mandible, 
and  the  majority  of  the  fibers  nm  ot)iiquely  to  tlie  median  raphe,  some  of  them,  however,  passing 
to  the  upper  border  of  the  IkkIv  of  the  hyoid  bone. 

Tho  musrU'  i<  supplird  hv  tin'  mvloludid  m-rvt'  fnmi  the  thinl  division  iif  thi'  trincminus.  DuriiiK  drglutilion  it 
oli-vatcs  itif  t-nlirr  llixir  i-f  thi-  mouth,  togothi-r  with  tlir  tonKUi  ;  itu-  hyoid  lionr  i^  al^o  drawn  upward  Iiy  the  filiirs  in^rrti><l 
into  it,  and  whi-n  the  hyoid  bom-  is  liwd,  the  musi  Ir  di|iriSMS  ilu-  lower  jaw,  a^sistinR  the  digastrii . 

The  geniohyoideus  (Figs.  257,  258,  and  265)  is  a  rather  strong,  slightly  flattened  muscle 
which  is  situated  between  the  muscles  of  the  ttmiiue  proper  and  the  mylohyoid,  the  inner  margins 
of  the  muscles  of  the  two  sides  being  in  immediate  t ontact.  Eaih  muscle  has  a  tendinous  origin 
from  the  m.  ntal  spine  of  the  mandible  (Fig.  257),  and  becoming  considerably  broader  as  it  ])asses 
backwanl,  has  a  fleshy  insertion  into  the  anterior  border  and  upper  .surface  of  the  Ixxly  of  the 
hyoid  hone. 

Thv  gi-niohvoid  i^  supplied  liy  IiImts  from  the  first  and  scrond  rcrx-iral  nerves,  whirh  aeeomp  i  ■•  llie  hypoglossal 
n<r\e.  It  draws  the  hvoid  hor-  forward,  or,  when  the  hyoid  l)one  is  fiNed,  it  (U'lirisses  the  lower  j.i  .  Together  with 
the  infrahvoicl  and  the  jiosli  rim  si-pr.diyoid  mus.  les.  it  fixes  the  hyoid  lione. 


THE  DEEP  MUSCLES  OF  THE  NECK. 
The  Group  of  the  Scaleni. 

The  scaleni  (Figs.  244,  247,  25S.  and  2;,()i  are  t()m]iosed  of  three  (rarely  four)  muscles  which 
iia.ss  from  the  transverse  jirocessi'S  of  the  cerviial  \titebra'  In  tin  first  and  Mcond  ril)s.  Their 
origins  are  concealed  by  the  sternocleidomastoid,  but  they  are  partly  situated  immediately  beneath 
the  skin  in  the  lateral  iirvical  region. 

The  scalenus  anterior  (Figs.  247,  258,  and  2;()!  is  a  long  nuiscle  which  is  almost  wholly 
covered  by  tlu'  sternocleidomastoid  an<i  luirtly  so  by  tile  inferior  1h  liy  of  the  omohyoid.  It  arises 
by  tendinous  slijis  from  the  anterior  tulHrcle>  of  llie  transverse  proiisses  of  the  fourlli  to  the  sixth 
cervical  vertebra-,  and  jtasses  downward  and  forwarii  to  the  lirst  rib,  becoming  narrow  ami  tendin- 
ous at  its  insertion  into  the  scalene  tiilunlf.  The  anttrior  surfaie  of  the  must  le  just  alxi\-e  the 
»    insertion  is  provided  with  an  aiioneiirosis. 

The  scalenus  medius  d'igs,  258  and  251))  is  longer  and  usually  strong!  r  than  the  anterior, 
with  which  it  is  closely  relateii  by  it-  short  iiridons  of  origin.  It  arises  fmm  the  anterior  tuberiles 
of  all  of  the  cervical  vertebra'  and  is  situated  to  the  outer  side  of  and  ]iartly  iKiiealh  the  scali mis 
anterior.  It  is  insertid  bv  a  broad  short  tendon  into  the  outer  surface  of  the  first  rib  alK)Ut  a 
fmgerbreaillh  to  the  outer  side  of  tlu  si  alenus  anterior. 

Hetweei>  the  insertions  of  the  scalenus  .interior  and  medius  into  tin  first  rib  there  is  a  space 
which  gives  pass;ige  to  tl.e  sulnlav  ian  arti  ry  and  to  tlie  gnater  part  of  tin  brat  hial  plexus. 

The  scalenus  posterior  (l*ig>.  vu  aiii  -sifi  i^  tlie  smallesl  oi  tin-  siuKiu,  and  is  ininunily 
adherent  to  the  medius,  from  which  i|  i-  di--tingui  hable  onlv  by  its  separate  insertion.  It  arises 
fmm  the  transverse  pr<H'es.ses  of  the  iifih  to  the  st   enih  >trvical  vertebra',  is  situated  Ixtween  the 


[ill- 


H 


i|! 


iiN' 


'  iii  % 
■  i  s 


176 


ATLAS   AND   TEXT-BCOK   OF   HtJMAN    ANATOilY. 


scalenus  mcdius  and  the  levator  scapula-,  and  is  inserted  by  a  short  tendon  into  the  upper  border 
of  the  second  rib.     Its  insertion  is  covered  by  the  upper  digitations  of  the  serratus  anterior. 

There  is  occasionallv  present  a  small  independent  muscular  fasciculus  situated  Ix-tween  the 
scalenus  anterior  and  mwlius.  It  is  known  as  the  scahnus  minimus,  and  is  inserted  into  the  f^rst 
rib  and  also  into  the  di-me  of  the  pleura. 

The  s.al.ni  r.>  .iv  ,l,oir  ncrv..u,,,,ly  ,,ar,ly  fn,m  the  ..-rvi...!  plexus  a„.l  partly  Che  scalenus  posteHor,  fr.,m  small 
spe.  ial  t.ran>  hes  of  the  brachial  plexus.     They  elevate  the  tw„  up|.,T  r.bs. 


ii!    I 


ii 


THE  PREVERTEBRAL  CERVICAL  MUSaES. 

The  muscles  of  the  prevertebral  group  (Figs.  258  and  250)  are  situated  to  the  inner  side 
tnd  ah.ve  the  scaleni,  from  which  they  are  separated  by  the  transverse  pnxesses  of  the  cervical 
vertebra-      Thev  are  the  /<;h?«.v  colli,  the  hmi^us  capitis,  l,  ul  the  rectus  capitis  uutcrwr. 

The  longus  colli  ( Fig.  2^.,)  is  a  rather  thin  Hat  muscle  which  is  situate.1  between  the  cervica 
viscera  and  tlv  bo<lies  .,f  ihe'upper  thoracic  and  of  all  of  the  cervical  vertebra-.     Its  upper  ant 
outer  portion  is  cverctl  bv  the  longus  capitis,  and  between  the  two  muscles  and  It,  either  side  (.f 
the  metlia.,  li.ie  thert  i>  a's,,ate,  the  width  t.f  the  little  fmger,  in  which  may  be  seen  the  anterior 
l„ngilu<linal  ligam.m  of  the  vvrtebral  column.     The  muscle  has  the  form  of  a  very  obtuse-angled 
triangle,  the  obtuse  r.ngle  being  placetl  at  the  transverse  prt.ce.,s  of  tiie  sixth  cerMcal  vertebra. 

1,  i,  composed  of  llirte  portions,  each  of  which  c.mstitutes  a  side  of  the  inangle.  1  he  mner 
portion  is  the  longer,  an.l  t  xtend.  from  the  btnly  of  the  thinl  thoracic  vertel)ra  to  the  axis  It 
arises  bv  tentlinot,.  slips  from  the  l^nlies  of  the  upper  thoracic  an.l  the  lower  cervical  vertebra- 
,n<l  insc'rls,  nartlv  bv  muscular  an<l  juirtly  by  tendinous  tissue,  into  the  botlies  of  the  upper  cervical 
vertebre  The  »/>^r  an,i  o.tcr  portion  arises  by  Hat  tendinous  tligitati.ms  fr.m  the  anterior 
,t,l,ercles  of  the  transverse  processes  ..f  the  upper  tervical  vertebra  antl  is  inserte.l  into  the  antenor 
tubercle  of  the  atlas,  this  ,.ortion  being  sometimes  termetl  the  lou^us  allantis,  and  also  mlo  the 
l.Klies  of  the  im.lerlvi.ig  . .  rvit  al  ^t■rtebra■  in  common  with  the  inner  segment  ot  the  muscle  I  he 
/.v,r"and  outer  portion  ..ises  from  the  lateral  surfaces  t,f  the  Uxlies  of  the-^  upi>er  thoracic 
vertebra-  an-i  is  inserte.l  by  tiie  tt  n.iinous  slips  into  the  transverse  prt.cessc-s  of  the  lower  cervical 

'''  '-riH'  longus  capitis  (rectus  capitis  anterior  major)  (Figs.  258  an.l  25.)!  is  a  rather  broail  Hat 
muscle  the  upper  p.,nion  .,f  ^^hi.  h  is  somewhat  timkene.i.  It  lies  t..  the  outer  si.le  of  the  It.ngus 
colli  an.l  ...vers  its  upper  ami  outer  segment,  an.l  arises  by  .listinctly  separatetl  ten.hnous 
tlig.tations  in.m  the  anterior  lulxrcl.  s  ..f  the  transverse  proces-  s  .,f  the  th.nl  t..  the  sixth 
eervital  urlebrav  Fn.m  these  origins  it  passes  upwanl  ami  slightly  inwar.l,  ami  is  inserted 
i„l„  the  lowtr  surfa.e  ..f  the  basilar  iK.rtion  of  the  occipital  iH.ne.  There  .s  a  .l.stnul  aponeu- 
...,.;.  .,.....,  .1 ,tt.r;,,r  tnrf.ur  i.f  the  muscle  somewhat  al>ove  its  mifl.lle. 

The  lonuu.  ,..lli  an.l  .he  longus  ,  api..,  are  ,uppli.-l  bv  N"<  i^'l  '-""'h-  ■•'  <h.-  ..Tvi.al  plexu.      Th.-y  In-nd  the 

„.n.i,         e  tlal  ,..lu,„n  a,.,e ',  an,:!  ^h.n  thev  a,,  u .Tallv.  „ he  he. wan.  the  ...e  „(  '   '  •'•n-'-^ 

ntuvle,     In  the  .urr,in«  movement,  the  l.,n«u .i»  «n,l  the  upper  an.l  outer  s.„men,  o,  the  lonRU h  a,,  .oguh.r. 


THE   MUSCT.F.S   OF   THE   HEAP. 


T77 


The  rectus  capitis  anterior  (minor)  (Imr.  250)  is  a  small  n^usclc  i>assin^  hcUvei-n  the  atlas 
and  the  occipiuil  bone  and  is  almost  entirely  concealed  by  the  longus  capitis.  It  arises  from  the 
base  of  the  atlas  and  passes  upward  and  inward  behind  tb.e  insertion  of  the  lon-us  ea„.>is.  to  l)e 
inserted  into  the  under  surface  of  the  basilar  process  of  the  occipital  l)one. 

B,>th  .he  funriion  ami  ih.  inn.-rvalion  ..f  ihis  musclo  an-  intimat.ly  .onn.TU-.l  with  thoso  of  th.  ,,ro>.-,lmK  onrs, 

THE  FASaiE  OF  THE  NECK. 

In  the  neck  two  fasclic  mav  be  distinguished:  the  rrn'iai!  jasria  an<l  the  prr.rrUhral jasda . 
The  cervical  fascia  is  further  sulxiivided  into  a  superficial  stronf^er  and  a  deeper  weaker  layer. 

The  supvrfuial  layer  of  the  cen'ieal  jascia  covers  /.le  sternohyoid,  the  sternothyreoid ,  the 
thvreohvoid,  the  anterior  surface  of  the  sterncKlei.lomastoid,  the  inferior  belly  of  the  omohyoid, 
the  posterior Mlv  of  the.lit^astric,  the  stylohyoid, the  submaxillary  -lan.l,and  the  carotid  foss;i;  it 
is  itself  conceale.i  bv  the  pUuvsma.  This  superficial  layer  is  connected  alx.ve  with  the  narotideo- 
masseteric  fascia,  and  also  covers  in  the  space  between  the  ,.osterior  iK.rder  of  the  si.  ii.Hleido- 
mastoid  and  the  anterior  Ixirder  of  the  trapezius. 

The  deep  hnrr  oj  the  eercieal  jascia  unites  with  the  superficial  layer  at  the  anterior  Ix.rder  of 
the  sternocleidomastoid,  so  that  in  the  mi.UUeof  the  neck  but  a  sin-le  lay.r  <.f  fascia  covers  the 
larvnx  and  the  upper  portion  of  the  trachc'a.  It  covers  the  iK)sterior  surface  of  the  sterno<le.<lo 
mastoid,  which  is  conseriuentlvensheathal  Ix-tween  the  two  layers,  the  posterior  surface  of  the 
posterior  M\\  of  the  diRastrie  and  of  the  stylohyoid,  the  tl<«.r  of  the  caroti.l  fossa  and  the  sealeni. 
It  is  intimatelv  adherent  to  the  intermediate  tendon  of  the  omohyoid  and  l)ehin<l  the  manubrium 
of  the  sternum  it  extemls  .lownuanl  to  the  first  rib,  while  posteriorly   it  is  continuous  wnh  the 

nuchal  fascia.  .11 

The  preverlehrnl  jasria  is  a  rather  dense  layer  of  fascia  which  < overs  the  i.revertel)ral  muscles 
and  the  anterior  surfaces  of  the  cervical  an<l  of  the  ui)per  thoracic  vertebrx.  It  is  separated  from 
the  cervical  viscera  by  l<K)se  connective  tiisue. 

1 1„  ,1„. .  ..rvi.  al  r>Kio"  ^'«."n  th.  ,u|M,Kra,,hi.  al  r.-la,i.m>  of  .1,..  mus.  U-s  arr  far  fn,m  a«nrinK  will,  ,h.-ir  .l.-v.lnpm.mal 
rclaliuns,  n,anv  ..f  llu-  mu.s,  l.s  ,lrs.rilH.l  al».v.-,  su,  h  a,  Uk'  plaly.ma,  ll,.-  ...-rn.K  Ui,|o,r  ■  ...a.l,  a„.  all  ih.  supralnnwl 
mus,  l,s  will,  tlic  fNcoptinn  ..f  thr  Kcninhyoi-I,  iKlonRinR  U  tl.r  ■  ranial  mus,  uialur.-  11.,  tru.- .  ,rv..  al  nuis,  ks,  ,. ,  ,  .!>,.„■ 
(U  rived  friMii  tile  eervi,  al  my,Homes.  may  l)e  i  lassifieil  as  fi>ll,ms: 

Hyi>,isk,l,lal:    lmii;iis  inlli.  Iiin!;iis  ■.J/>///<.  and  rrr/id  ni/>i/n  ,inwrwr- 

Re<tus:    steriwhywlcu^,   ^l.-riiollivrniideiis.  IhvnnliyoiJnis.  au<l  imwhyoidnix. 

Ohli.iue:    tnitfiu  (and  prohalilv  als,i  th,'  iiilirlr,iiinTr'..irii  .nilrriorrs). 

As  has  alr,.a,lv  In-en  |M,int,'d  ,ml,  ihe  mus,  ulature  ,.f  .1.,-  ,liai,l,raRm  is  also  .lerive.l  (nm.  ih,'  .  ,rvi,  al  mv„t,.nu-s  an.i 
is  |)r,il)at)ly  tu  be  regardeil  as  d  iMirtiim  ,it  the  .iMiiiue  Rroup.— Ku] 


THE  MUSCLES  OF  THE  HEAD 

The  muscles  of  the  head  are  composed  of  two  larRe  and  completely  independent  groups:  (0 
The  cutaneous  mus.le.  of  ihe  head,  i.  c.  mu:.cl,s  which  ari-e  d:re<!!y  "r  i»dimtly  from  the 
cephalic  skelet-m  but  which  are  inserted  into  the  skin  of  the  fac.'  or  scalp  or  are  situated  in  the  skin 
of  the  face;  and  ( 2 )  the  muscles  of  mastication,  which  are  typical  skeletal  muscles  in  every  resinrt. 


178 


ATLAS   AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 


Fig.  260. — The  superficial  layer  of  ttie  facial  muscles  and  the  neighboring  muscles  of  the  neck  seen 
from  the  side  and  siightly  from  in  front. 

Fic.  261. — The  orbicularis  oculi  seen  from  behind. 

The  musric  together  with  the  integument  has  l«;en  removed;   the  lachrjmal  portion  is  represented  in  connection 
with  the  inner  margin  of  the  orbit. 


THE  MUSCLES  OF  THE  FACE  AND  OF  THE  SCALP. 

The  cutaneous  muscles  of  the  face  exhibit  manifold  peculiarities  by  which  they  arc  more  or 
less  differentiated  from  the  ordinary  skeletal  muscles.  They  jwsscss  no  fascia',  they  exhibit  but 
a  slight  degree  of  indcjiendcnce,  and  many  of  them  are  so  combined  and  their  fibers  interlace  to 
such  an  extent  that  it  is  often  purely  a  matter  of  choice  whether  individual  fasciculi  arc  regarded  as 
sjiecial  muscles  or  as  the  heads  of  a  larger  muscle.  The  arrangement  of  the  facial  muscles  into 
sphincters  or  muscles  of  ckxsure  is  also  characteristic.  The  group  includes  the  epicranius  as 
well  as  the  muscles  of  the  face  jiropcr. 

THE  EPICRANIUS. 

The  epicranius  (Figs.  260,  262,  and  264)  consists  of  a  middle  aponeurosis  which  cnvelojis 
the  cranium,  the  galea  aponciirotica,  and  of  muscles  which  arise  in  the  frontal  and  occipital  regions 
and  are  inserted  into  the  galea.  This  is  thi-  k.  st  in  the  occipital  region,  becomes  thinner  toward 
the  forehead  and  ]iarticularly  toward  the  temjiles,  and  gradually  loses  its  ajioneurolii.-  character 
(especially  in  the  temjioral  region).  It  is  connected  to  the  skin  bv  fibrous  connective- tissue 
fasciculi  and  sejiarated  from  the  cranial  periosteum  by  l(X)se  .T'^olar  l'   • 

The  frontalis  is  a  very  thin,  broad,  and  Hat  muscle  wj-  is  intiri;  'ely  adherent  to  the  skin 
of  the  eyebrows.  ';  has  a  broad  origin  above  the  supraorbital  margin,  ■  xtendsover  the  vertical 
jiortion  of  the  frontal  l)one,  and  is  inserted  into  the  galea  aiioiieurolica  in  the  upper  ])ortion  ol  the 
forehead.  It  has  also  a  slender  origin,  which  \aries  in  si/.e,  from  the  l-Miy  bridge  of  the  nnse; 
when  strongly  developed,  it  i-  known  as  llu-  frorrnis  ( pyramidal  is)  nasi,  but  it  is  always 
immediatelv  connected  with  the  frontalis.  The  two  frontales  are  separated  in  the  median  line 
by  a  narrow  area  containing  no  muscidar  tissue. 

The  occipitalis  is  also  a  Hal,  broad,  and  an  apiiroximalely  (luadrilateral  must  le  wliii  h  atises 
on  each  side  by  short  tendinous  fibers  from  the  highest  nuchal  line;  il  passes  upward,  and  after 
a  comparatively  short  course  is  inserted  into  the  galea  aponeurotita  in  the  occipital  region.  The 
width  of  the  muscle  is  much  greater  than  its  height,  in  contrast  to  the  opposite  condition  in  the 
frontalis. 

Like  all  the  fa(  iai  nius.  Ii  -,,  the  frontalis  and  ihe  iki  ipitalis  are  supplied  by  the  fai  ial  nervi-. 

Both  musdes  are  tePMirs  of  the  galea  aponi-urotii  a.  They  pull  the  si  alp  forward  or  baikw.ird,  and  the  fr  italis 
wrinkle^  the  skin  of  the  fonhiad. 

,\  portion  of  the  aurirularis  is  also  related  to  the  galea  ajwneurotica.  This  muscle  jiresents 
three  portions,  an  auriiuUiri-.  anterior,  superior,  and  posterior,  and  like  almost  all  the  facial  muscles 
they  arc  subject  to  great  individual  variations  in  'he  degree  of  their  develo]iment. 


Lilr  palpehrale  iiinHale 
Procerus 


I  Angular 
head 
In/ra- 
orhital 
tahii  head 


super. 


Zygo- 
matic 
head 


Trunsvcr^iis  7< 


Occipitalis 


Fig.  260. 


I  roiitni  hnitr 


t.achrymal  portion 

Lachiy^^ii!  -oc- 

f'ossa  /or 
luihryr'iii!  sar 


' 


Fig.  261. 


'■ 


li  i  I 


M« 


t 
1  i; : 


N 


iiill 


THK    MUSn.KS   OF   THE   FACF.    AND   OF   THF   SCALP. 


179 


The  auricularis  anterior  {attriihens  aurktihr]  (¥{%.  2f)o)  has  a  very  thin  and  usually 
quite  a  small  origin  from  tlu  suiKTtuial  temi)()ral  fascia  (see  juige  184);  whin  well  develojied, 
the  muscle  extends  lo  the  frontalis.  It  is  inserted  by  a  short  tendon  into  the  cartilage  of  the 
auricle  and  into  the  eartilagino\i>  external  auditory  meatus. 

The  auricularis  superior  (attollcns  auricuhr)  (Fig.  2f)o)  is  u>ually  the  strongest  portion  of 
the  auricularis.  It  arises  broadly  from  the  galea  aponeurotica  abow  the  tem])oral  region  and 
becomes  markedlv  narrower  as  it  descends  to  be  inserted  by  a  tendon  into  the  upper  margin  of 
the  root  of  the  auricle. 

The  auricularis  posterior  inlraliciis  auricula-)  (Fig.  264)  consists  of  one  or  more  flat  slender 
fa.M  iciili  which  arise  over  the'  tendon  of  the  sternocleidoma.stoid  and  are  atlac  bed  to  the  posterior 
e.xtiemity  of  the  root  of  the  auricle.  The  Irnusvirsus  nurJi<r  (see  jiage  14O)  which  is  not  inlre- 
quently  present  pcjssibly  al>o  belongs  to  the  auricularis  |)osterior. 

Till'  film  li- 'IIS  of  ihf  imlividual  |Hirti>ns  "f  tin-  Miirii  iilaris  an'  tii  movr  llif  aurii  It-  in  l)n'  (liriilioii  of  ih,-  nius.  ular 
MIkts.     Thi  inri'    .  ation  i<  frowi  tlu-  fai  ial  lUTvc. 


THE  PROPER  MUSCLES  OF  THE  FACE. 

The  remaining  muscles  of  the  face  pro])er  are  composed  of  three  groups:  the  pulpthral 
musch'S,  those  surrounding  the  orbital  orifice;  the  oral  musdi.s,  those  situated  about  the  mouth: 
and  the  itasai  nnisclcs,  those  >i!uated  upon  the  nose. 

THE  PALPEBRAJ.  MUSCLES. 

The  palpebral  musculature  forms  the  orbicularis  oculi  {palpebrarum)  (Figs.  260  and  261 1. 
This  is  a  flat  muscie,  situated  <  hielly  in  the  ori)ital  region,  which  forms  a  broad  ring  about  the 
entrance  to  the  orbit,  and  is  comjjosed  of  three  ]iortions,  the  orhilal,  the  palpi  hral,  and  the  ladiry- 
mal  portion.  Onlv  the  last  ]K)rtion  possesses  a  certain  degree  of  independence;  tiie  orbital  and 
paljvjbral  portions  ar-  directly  i  cintinuou>  with  each  other. 

The  orbital  portion  forms  the  broader  external  circumference  of  the  mu^cidar  ring,  and  lies 
U]X)n  the  margin  of  the  orbit  inmiediaii  iy  beneath  the  >kin.  Its  broad  fasciculi  arisi'  from  the 
frcmtal  process  of  the  maxilla  and  the  adjacent  ]iortion  of  the  frontal  l«in.  .  and  pass  in  a  wide 
curve  alK)Ut  the  '  ntrance  of  ihr  orbit  to  return  almost  to  their  -tarling  jioini  at  the  inner  canthus. 
The  muscle  is  connected  witii  many  of  its  neighbors,  i)articularly  with  the  frontalis,  and  til)ers 
which  radiate  into  the  skin  of  th<  eyebrow  constitute  what  is  ti-rmed  ilic  (orrut^al'tr  siipcrrUii 
(Figs.  262  and  2(>4),  while  others  w  hich  pass  to  the  cheeks  are  known  as  the  walar  portion  ol  the 
muscle. 

The  palpebral  portion  is  the  more  posterior  portion  of  the  muscular  ring,  and  is  that  jiart 
of  the  muscle  wiiich  is  situated  within  t'ne  eyelids.  The  fibers  ol  the  muscles  of  Ixnh  the  ujiper 
and  the  lower  lid  ari-e  at  the  inner  canthus  from  a  short  hori/onial  tendinous  band,  the  inlirual 
palpebral  lifiniiient,  and  pass  as  line  fasciculi  in  an  arched  manner  to  the  outer  canthus,  where  they 
are  partiaiiv  inlerlan  d  and  foim  die  ,\lerndi  pdip,hral  rapiic.  [Vv.r  a  further  dcss nplion  ol  the 
relations  of  the  I'iIkts  in  the  eyelid  itself,  see  "Atlas  and  I'.pitome  of  Histology,"  Sobotta  Huber.) 
The  laelirymal  portion,  also  known  as  Horner's  musili  (Fig.  2(11  ),  is  a  deeply  situated  portion 
of  the  muscle,  which  is  connected  with  the  ]ialiiel>ral  portion.     It  arises  from  the  jiosterior  k'c  hry- 


m^ 


,^:^- 


I 


Hr 


ilk':'      S 


J     ( 


'     i 


:M! 


^g 


1 80 


ATI.AS    ANI>    TKXT-BOOK    OF    HI  MAN    ANATOMY. 

Yu.    ^0^.— Tho  (Icencr  laver       the  farial  mustics  ,    ■    ,       , 

The  „.a,...u .  lalni  supcriori:,  ;,,„„K,,i.  u.  ,nL«u,ans,  „ Ira.us  lahii  i.Uri.n.  tlu-  „an,„.U.o-n,assc.on,  fa.  M. 


tho  parotid  i;l.inii. 


t  a  iHirtion  of  .h.-  -^uiHTrii  iai  layi-r  of  the  li-ni 


,|Miral  fa~(  ia  have  been  renlovcl. 


Fi(     2()(  —The  oral  musculalurc  seen  from  bchiiul. 

The  mus,  le.  ,.,KeU,er  w„h  .h:  ime,u.nent,  have  bee.  separaU-l  fn,„,  .he  hones  a,vl  .h..  mu.nus  nu-.^hrane  e„ver,n^ 
the  mu^iles  ha^  been  n  muveil. 

n.al  ri.l.'c  of  Uu-  lachrvmal  Ix.n.  and  the  fibers  i>ass  hori.t.ntally  acn.s  the  lachrymal  sat  to  tl. 
I^ar  "nCof  the  litis,  whert  :  -^  v  clecus.ate  antl  tlisappear  ia  the  fibers  t,f  the  palpebral  port.on.    <  \ 
more  tlelailetl  tlest riplion  uii!  !«   f'>uml  in  the  seetitm  upon  -  Fhe  K>e.   ) 

The  ,.,.u,ans  „et„.  h.e  au ,.  the  ^^f----;^;:^-;-;:,  ^ ::::';:::"  z^^i'::  r:ntrat,„ ..  .he 
^.j::::::::::i::^X;::::u^^^^^  -^ 

the  [..rehead    -.vrinkle  the  -km  in  th.  m-  legion^. 

THE  ORAL  MUSCLES. 

The  nntsdes  of  the  oral  regit.n  consist  of  the  buahuUor,  of  the  circttlar  m.trs  situau..!  ab.mt 

the  mouth  which  form  the  orbicularis  oris,  t,f  the  mu.cles  t.f  the  upper  hp,  o,  the  njuscles  of   le 

:  lip,  of  muscles  which  are  situate.l  upon  the  sUin.  and  of  muscles  wh.ch  -hate  ,m.,      e 

anis  tlf  the  mt.uth.     The  ^reat  majority  of  these  muscles  are  .nfm.tely  connectetl  ..th  each 

""''"•rhe  quadratus  labii  superioris  <Fi,..  260  and   .62)   is  situate.l  in  the  upper  lip  in  the 
nasal    infraorbital,  malar,  buccal,  antl  superior  labial  regions.  ,      ,      ,  r         ,, 

U  ha-  in  general  a  triangular  shape  antl  arises  by  three  heads:  the  a„,uor  ua.l  rom  the 
bt,nv  hritlge  t-f  the  nose  in  conne.tion  with  the  frontalis  antl  the  orbicularts  otuh;  the  n,,raorual 
hZ<  arising  broa.llv  from  the  infraorbital  margin  antl  coveretl  by  the  orbua!  porUon  o  he 
o^bi^ulari^^culi;  antl  the  cv„.»„//,  lu.nl,  a  slen.ler  fasciculus  fn.n  the  malar  surface  ot  the 
zv-omali.   bone,  which  i-  usuallv  a.lherent  to  the  lateral  ra.liati.ms  of  the  orbicularis  ocuh. 

■  "  The  an,ul„r  hcul  .Icvalor  lahii  suprrioris  aUcquc  nasi)  is  compost-l  of  two  pt.rtions,  an  inner 
one  passin.Mo  the  ala  of  the  nose  ilcvator  al.r  .u.uU  an-l  a  stronger  outer  one  whith  unites  .,th 
Z  uvo  otl^r  heatU  of  the  t.ua.lratus  antl  passes  ,0  the  musculature  t,f  the  upper  hp  near   he  innt:r 

idc  of  the  angle  of  the  n..uth.     The  iujraorlnlal  haul  .Irvator  lahu  suprrnms^  is    he  broa.le  t, 
^  the  s,>me^d.tt  intonsiant  cyt:.mt,//c /.c,./ ,.v,,.m.//n.  ./..n  tlK.  U 
At  the  insertion  of  the  .,ua.lratus  labii  superioris  into  the  upper  hp  Us  muscular  fibers  interlate 

with  those  of  the  orbicularis  oris. 

The  zygomaticus  i,.,om,tirus  maior^  (Fig.  .<.o)  is  an  elongatetl,  rather  strong,  antl  eas.l 
ist,la,cd  mu^le  which  is  shuatetl  in  the  malar,  buccal,  an.l  t.ral  regions.       t  has  an  in.lepentlent 
r  g in  from  the  malar  surface  of  the  malar  bt.ne,  close  besitle  the  zygomatic  hea,  of  the  t.uadrat^ 
Z^\  superior.,  an.l  rtins  to  the  angle  of  the  mouth,  where  it  fuses  with  the  orbicularis  oris  and 

the  neiirhl>oring  mustles.  .  ,        •  1 

The  risorius  or  "smiling"  muscle  (ligs.  360  and  .6;)  is  a  thin,  approximately  triangular 
mustle  of  variable  tlevelopment  which  is  situate.l  chielly  in  the  par.iti.leo-massctenc  anc  buccal 
"gi<!,r!s.     It  arises  frt,m  the  partuitleo-masseteric  fascia  (see  page   .84),  st>metimes  exten.l.ng 


Cormgator  supt'riilii 

Quadratus  \ Angular  head 

labii       \  Zygomatic  head    " 
superioris   \j„fraorbital  head 


Zygomaticus  x 


Quadratus  lahii  infer. 


Trapezius 
'Spleniiis  capitis 


ill 


Depressor  sepli  Inciwus  labii  superioris 

Hi 


■f*  Buccinator 


Triangularis 


fig.  203. 


ill 


lll 


!f 


THE   MUSCLES   OF   THE   FACE   AM)  OF   THH  SCAM'. 


l8l 


upward  as  far  as  the  zv^oma  and  covcrinK  the  radiating:  fitxTs  of  the  j)hitysnia  in  this  situation. 
The  lower  portion  of  the  mu.seie  is  eonnetted  with  the  platysma  and  fre(|uenlly  apjiears  to  he  a 
direet  eontinuation  of  some  of  the  individual  fas.ieuli  of  the  latter  muscle  ( Fij,'. -'(.7  i.  It  is 
inserle.l  into  the  laijial  musculature  at  the  ang'e  of  the  mouth  immediately  l.elow  the  /y-o- 

maticus  major. 

The  triangularis  >ntiii;ul,iris  hibii  injcriorh  or  </</)rc.v.s«r  ,i)ii;i<li  oris)  (Imk.  2601  forms  the 
superfuial  laver  of  the  musculature  of  the  lower  lip.  It  is  a  Hal  trian-ular  muscle,  situated  in 
the  tnural,  mental,  and  inferior  labial  regions,  and  arises  broadly  from  the  anterior  extremity 
of  the  lower  Ix.rder  of  the  body  of  the  jaw.  Its  libers  are  inMTled  into  the  laliial  musculature  of 
the  lower  li])  near  the  angle  of  the  mouth,  some  of  its  >^uperfn  ial  fasciculi  j.assing  to  the  opjxisite 
side  in  an  arche.1  manner  [n  f(,rm  a  single  subcutaneous  nuisde  which  i-  known  as  the  :r,iiisv,rsus 

lUiiili  (Fig.  2(k)).  .     . 

The  (|uadratiis  labii  superiori>,  the  /.ygomaticu>,  the  ri^oriu>,  and  llie  lriangulari>  lorm  the 
superficial  layer  of  llie  oral  mus.  les  and  con(eal  tiie  greatir  nunil)er  of  tluoe  wiiidi  are  now 

to  be  des(  ril)ed. 

The  caninus  ari,nii;iil,iris  l.ihii  suprrioris  or  Irr.ilor  ,iit,^iili  oris]  iFigs.  j(.o,  j()j,  and  -'(141 
arises  from  the  canine  fossa  of  the  n  axilla  and  passes  into  tile  mus.ulature  of  ill.  lip  above  the 
/.ygomaticii-.  It  is  a  ilaltened  elongatid  mus.  le  and  i-  iilmost  entirely  (..ncealed  by  ih,  over 
Iving  i|uadratus  hibii  siqierioris  and  /ygomaliius. 

The  quadratus  labii  inferioris  k/,  />r. xv.-r  hihii  ii:j,rioris  1  1  Figs.  j(.o.  .■(•-•.  and  .-o  1  >  i-  a  ilai 
(|uadrangular  nuivlr.  the  posterior  portion  of  which  i>  lov.ivd  by  tiie  triangulaiis.  it  arises 
from  the  :inlerior  cMremiiy  .'f  tin-  lower  iM.rder  of  the  jaw  and  passe,  to  the  orbi.ularis  oris  in 

Ihe  lo\u  r  lip. 

rii(  incisivi  </dl>ii  siipcrioris  ,1  injrrioris]  .Fig.  .■'vv  ^ire  small  slimier  nuisdes  which  arise 
from  the  alveolar  juga  of  the  superior  and  inferi.>r  l.il.ral  incisois  and  jiass  dire.tly  into  the 
musculature  of  ihe  orbit  iilaris  oris. 

The  orbicularis  oris  ../-///m/.r  ,t/m  (Figs,  joj  ai;.l  .'Oy  is  the  mus.  le  which  surroun<ls  the 
mouth  and  f..rnis  ihe  ,,n.p-r  nnis,  ulalure  of  ihe  bps.  The  fas,  i.  uli  of  the  mus,  le  run  in  .|iiit,- 
,lir!Vr,nt  , lire,  lions  and.  at  the  angles  ,,f  ihe  ni.uilh  ;.n,l  111  Ih.iIi  llu-  upper  Mii.l  lower  lips,  ;,,,• 
inlimauly  ,onn,-,U<l  v,  i:!i  llie  iilie.soi  l.,,ih  .piaibali,  llie  iriangul.iris,  llu  ,aiiinus,  ih.-  risorius, 
Ihe  /ygomali,  us,  ami  the  buxin.ilor,  s,,ni,-  of  \\w  lili.  is  ,,f  ili.-,-  nuis,  l,s  |>.,,sinu'  in  ill.  sanu- 
,|ir.'cli."^.n  a-  ill.'  fas,  Villi  .>f  th.'orbi.  ularis.,ris.  In  a.l.lili.m  lo  ilu  lil  ris  ^^Wu  h  .  n.  in  I.-  ih.'  inonih. 
,|„,  ,,,|,i,  Iilaris  ,,ri-  al-o  |,osm->ms  ..^.in.il  an.l  x.rli.;-!  I,is,  i.  uli'  llu  lall.r  loiiu  a  siu.ill  ~l.  lul.  r 
mus,  le,  situal..!  al..n-si,U.  of  llu-  nu-.lian  liiu'  ..lilie  npp.  r  lip,  uin,  '>  '  ■  iiis.n.'.l  inio  llu- .  an  il.iL'iii 
..Us  nasal  s,-|,ium  and  is  knoA-  as  die  ,1,  pnysiir  w  /-//  w/./wi  1  i'ig.  .•(.,;'■ 

'I'll,  mentaliiS  /.;.//."■  -■,»;// ..r  h  :ol,>r  l.ihii  injiriori^  1  l-igs.  ..(..■  lo  .(.|  i  1  s|„,ri  mus.  I. 
silual.-d  in  llu-  in.iilal  r.  gion,  vnIiuIi  aiiMs  (n-m  llu-  l.m.  1  jau  n.-,ir  \\u  .ib.-l..i  iat'uni  ..|  llu 
me.liaii  in,  is,>r.  S.nu-  ..f  llu  .ir,  liini;  IiIh  rs  uniu-  wilh  tlu.s,  ,,|  ilu  nii.s.  |.  ,.|  ih,  opp..  ii.  -Id.. 
but  th;  gnaU-i  iiiinil'.r  an  iii~.il,-.l  mio  ilu  ml. -uni.  nl  o|  ili,  .  Iiiii.  Ih.  .origin  .•!  b.'lh 
menlali-s  is  ,,.\i  nd  b\  llu  <|ti,i.li.ilus  kibii  inf.  riori-. 

The  buccinator  d-i-s.  ..(,,.,  -i).  an.l  .'OM  i-  a  llal  nn;s,l..  .M.  luiin-  Ul«..n  ill.  upi  .  1 
an.l  III.   lower  j..u.  an.l  siiual.,1  inim.  .li.il.  I\  Iniualh  ill.   bii.  .al  niii..Mis  nu  iiibran.  .     «  liilv  llu 


l83 


ATLAS-  AXD    TKAT  HOOK    OF    HUMAN    ANATOMY. 

Flc.  264. —The  (ici|H">l  layer  of  the  fiu  ial  mus(  les  and  liu'  temporalis. 


Till'  ianinu>,  tin   />x.iiiialir  an  li,  .i  |iMrtinn  of  ihi-  zyKomatic  lioiir  wiih  the  urigin  .if  iln-  mkissi-Iit  .in'l  ihc  tcmpur.il 

Flc.  265. — The  tui)  |)tervK"iilei  --een  from  the  inner  surface. 
The-  anti-rior  |Kinnin  .if  ihr  ^kul!  h.i^  hen  .iiviilnl  111  lli.'  ^axiiLiI  plaiu,  .uul  llii-  t<m|).iral  Imiih'  in  an  iil)li(|Uc  i.lanc; 
the  !'>n){ue  anil  siifl  pal. 11. •  h.ivr  U'lri  iiiiiov.il. 


i   I 


i 


antcrini  tx)nl(r  of  ilie  must  le  1  shixtIk  i.il,  ]);i>-iiii,'  into  ihe  orljii  ularis  oris  and  the  other 
muscles  of  the  nioiitli.     It  is  the  slronnest  imiscle  in  the  oral  region. 

It  arises  from  the  buccinator  ridge  of  the  niandihle,  from  the  ]«)sterior  extremity  of  the  alveo- 
lar process  of  the  maxilla,  and  from  liie  i)teryg<)niandil)ular  raphe.  The  pterygomandibular 
raphe  (pterygomaxillary  ligament :  is  emlx-dded  in  tlu'  iHiccojiharyngeal  fascia  (see  ])age  184)  and 
e\i<nds  from  the  hamulus  of  tile  inu  rnal  pterygoid  ijl.iie  to  the  jioslerior  Iwrder  of  the  alveolar 
]K>riion  of  the  mandible.  It  separate-  the  inu  inator  from  the  constrictor  ])haryngis  .suixrior 
(see••S])lan^hnolog\  ').  .\t  the  angles  of  the  mouth  the  lil)ers()f  the  Inu  cinalor  muscles  are  directly 
<()nt:niious  wiih  tho.se  of  the  orbicularis  oris,  whili  the  jiost*  rior  surfaces  Ijorder  immediately  uiion 
the  oral  muious  membrane.  The  .interior  portion  of  eat  h  muMle  is  covered  ])y  the  risorius,  the 
triangularis,  the  zygonialicus,  and  the  canihus,  while  the  |K>stt  rior  ])ortion  is  situated  Ixneath 
the  massc-ter  (see  jjage  i8.<i,  from  which  it  is  .separated  by  a  mass  of  fat,  (he  Inttial  jal  mass 
(Hii hat's  fat  mass). 

Till  buicinalor  i>  j.erforai.  •  by  the  parotid  dud,  and  the  small  bunal  gl.md-  rest 
directly   ijjon  the  mu.sile. 

THE  NASAL  r^USCLES. 

I'iie  musilc  of  the  n.-.  are  muih  less  imjH)rtant  than  those  of  the  inouih.  The  feebly 
develo|«fl  nasalis  <  l-'igs.  2<>j.  -•'.(.  and  j()()i  i^  ( oniiK)sed  of  a  transirrs,  portion  and  an  ali:r  par 
tioii.  The  Iraitsvirsi  portion  i-  .1  llat  .ind  \ery  thin  nuisile  i\liich  uri-ns  from  tin  up]>er  jaw  .ind 
i-  adherent  to  the  angular  head  of  tin  i|uadratu-  l.diii  Mi|HrioriN  u]Kin  lh(  bridgi  of  the  nn^v,  it 
is  united  with  its  ft  How  i,f;hi  <ip|.osii,  -iije  b\  nuati-of  a  thin  ajHmeun.  .dernie.l  the  (■(iw/>r.A.w<r 
narium.  llu  i,'/<(f  portion  .onus  from  tlu  al\if>l,!r  jngiim  of  the  iippir  tanine  tiMHh  and  goe^  to 
lilt  ..iriilagi  111  llu  al,i  of  llu  in  >m:  ii^  gii  .Her  |Mir!ion  i- i  mered  by  tlu  i|iiailr,itiis  labii  superi 
ori-.  .dthoiigh  ,1  --mall  portion  is  .lUo  1  ont  t  .ded  b\  tin  mbuul.iriN  ori-.  {"hi  .ila  of  the  nose 
ij-o  reteives  tor, I  nily  tin  inM-rtion.if  a  [Hirtion  of  the  .ingular  lu.iil  of  the  ijuadralus  labii 
NUperiori-. 


,\!l  III  111.  tr.ii..  1.  .  i.f  ;(ii  fan  i.r.i|irr.in  -upiili.  .1  In  ili.  I.i,  .al  ii.rvr.  Thiir  fun.  ti-m  i<  i.i  pr.nlu, .- ilic  mutenii  iilx 
..f  ix[.t.>-i..ii.  1 1....U1.  ..I  111.  III.  mill,  nil  iM  nil  in-  .  .|  ili.  Ii|...  .in.j  .  .niiprt  ,M.in  .i|  llir  miiunl-. ..(  the  nmulh  i  ,is,  in  IiIuhihk, 
till    liih  .  m.il.in. 


THE  MI.ISCLES  OF  MASTICATION. 

I  hi   nuiMlts  of  inasijia;'   ;i  are  tom|M>-td  of  four  -inmg  Mparale  muscles  which  an  dnidtil 
inio  iwi.  iiroiip^    iht   iir^t  K^'i^l'  i-~'  foriiud  In  llu   niasulir  ami  tlu  timpoiali^.    the  sen.nii  by  the 

ivMi    jll,  t  ,1'oitil  I. 

Ihi    masseter    Fig.  :(>})  U  a  ihiik,  >lrong,  .uul  apjiroximately  i|u,idrilalt  ral  mustle  whit  h 


(-Orrugator  , 
Procrrus 


QuadmtttS 
labii  sup.  X 

Zygomatiais  - 
Trianguiaris 


frapmiis 


:^plenius  capitis 


l'tcrvf<oitifiis  extfrniis 


y  Slyhliyoiiieus. 
j^  '^hli'pft'in'igfii^ 

stvloiil  />ioir\s 
^nloftiiiiiilihu/iir  lif^. 


.Am.  I'flii" 


fig.  2t)'i 


i 


THF.    MrSCLF.S   OF   THE   FACF,    AMI   OF    TlfK.   SCAI.P. 


183 


is  situaU'd  chicllv  in  the  paroikko-massc-ric  and  partly  also  in  the  zygomat.c  region.  Its  super- 
ficial iH,rtion  arises  bv  a  broad  aponeurosis  from  the  lo.er  border  of  the  an.enor  and  n.uldle 
thirds  of  the  zygoma',  while  the  d.ep  ,)ortion  take>  a  short  muscular  or.gm  Irom  the  lower 
border  and  the'  inner  surface  of  the  ,,osterior  part  of  the  zygomatic  arch.  I.>  <  hut  mserfon  ,s 
into  the  angle  of  the  jaw  and  into  the  adjacent  portion^  of  the  l..dy  .nd  ot  the  ramus,  the  deep 
portion  being  inserted  into  the  ramus  alH.vr  the  superUcial  portion,  wli.ch  conceals  n 

The  aponeurosis  cover>  more  than  half  of  the  length  of  the  muscle  an.l  usually  ,,enetrales 
its  interior  in  the  >hape  of  individual  serrations. 

The  masscter  is  covere.l  I.ehin.l  hv  the  i.arotid  gland,  whose  <luct  passes  transversely  across 
the  muscle,  and  in  front  bv  the  paroti.leo-masseteri.  fascia.  Its  anterior  portion  is  also  in 
relation  with  the  uppermost  portion  of  the  ri>orius.  which  i.  still  more  superhcal  than  the 
naroli,lc..-masseteric  fascia,  with  the  /.ygomaticus,  and  ,>artly  with  the  zygomatic  licul  of  the 
I.uadratus  labii  superiorly.  Onlvth.  lower  portion  of  the  muscle  is  situated  immediately 
beneath  the  fascia,  the  aponeurosis  being  usually  covered  l.y  a  layer  of  fatty  tissue.  It  covers 
the  inserti.-n  of  the  temporalis  an.l  i^  .eparate.l  from  the  buccinator  by  the  ft;/r,-.// /.;/  »u,ss  (s.r 
page  liS.'i. 

Th..  massrl.T  is  suppli.-l  l.v  th.-  „K,s«-„Ti,  l.ran.  h  ,.f  tl,..  .hint  .livi.ion  ..f  ,1,,.  Iri^wninu.  1.  .  los.-,  tlu-  ,nnu,i,  by 
bririKinK  thi-  Lw.t  jaw  1,1  ..mlact  willi  tli>-  ui>|mt. 

The  temporalis  i  rig.  204)  i>  a  i.n.ad  -f  nig  mu>cl.',  rather  'lal  in  ii>  '.tpper  porli,.n,  whi.h 
covers  the  plamim  t.mpurale  an.l  th..  t.inp..,.!  f.>ssa.  In  the  temporal  regi.>n  it  is  almost  sub- 
cutamous,  and  lakes  a  muscular  origin  fr.-m  the  entire  M.rfa.e  ..f  the  planum  temiH.rale  Ixlow 
the  inferior  temporal  line,  partiv  fn.m  the  anterior  i.orti..n  of  th.  temporal  to>sa.  an.l  als.> 
fr.>.r  .i«  -.verlving  .k-M'  I^'V.t  ..I  th,.  tem|.or:il  fascia.  Th.'  wi.l..  la.cicuh  ol  th..  nius.l..  .-on- 
vcr,«r  ym-ar.l  the  ...r..n..i.l  pr..c.>s  of  the  niau.libU.  ..n.l  in  .l-'ing  >-  beu.m.^  marke.lly  lendi 
nous  upon  th.  out.r  surfa.e.  Th.  y  .nibrace  the  entire  ape.v  of  the  process  and  upon  its  inner 
surfan'  extend  dowinvar.l  as  far  a>  llie  base. 

■I  ,„.  „„,.,  1.  ■■  -u,.,.li.  •!  I'V  >'"•  ■!■  -I'  '■  "'l-ral  l.ran,  l>,s  (r.„„  ,1„.  n,o,„r  ,.,r.i.,n  ,.f  ,1,.-  .l>iM  'l.v  -i-n  of  ,1„.  ,ri«,n,im„. 
1,-  „„„  1I..M  U  ...  .  I.-.'  .!..■  moulh,  ■.„..;;,«.  UW  llu-  ,„.>.>.  Ur,  llu-  |..u,  ,  muar.l  tlw  u|.|K.r  jau 

Th.    pterygoideus  externus  .Figs.  ,.,-  an.l   -'(-'.i    i-    a   triangular,    fairly  stn.ng   muscle 
vUiich  is  siuat.  lin  til.   i„frat.nip..ral  tnssa  U^tween  ih.'  i.mp.-ralis  an.l  the  pl.Tv^ouleiis  mt.T 
nu-       It  arises  bv  iwo  more  ..r  l.ss  .listin.ilv  M-parau.l  h.a.ls:  th..  larg.  r  an.l  int.ii...-  tn.m  ili. 
„ul.r  snrf.i.e  .-I'lhe  .mt.r  |.lat.-  ..f  the   pt.-yg..i.l  pr..ce~s,  from   ill.'   pvranu.l.d   l.nuvss  ..I   the 
,,,1,,,    |„„u.    an.l   troMi   the  tuber.Mtv  .,f  the  maxilla;    th.'   sniaii,-,    .u,.l  sup.ri..r  ..„.■   fn.m  th.' 
infral,mp..ral  crest   an.l  s„vfa.,'  ..I    llu    givai.r  uin«  ..t    th.    sph.n.-i.i   1.......      I  h.    tw..   h.a.ls 

unii.'    ih.'  pu.scle  l»...m.^  n.ark.'.llv   nar...wci,  an.l  is  in^.rh.l    bv    a    sh,,r,    t.n.l.-n    nito   t  ,,■ 
ptcryg....i  lo-a  ..f  tlu   h.a.L.f  ilu^  man.libl..  som.' td..Ts  passing  a!s,,i..tlu   articular  .lis,  ..f  the 

li-miioroni-i\illar\  arli.  tllalion. 

I'hr  pterygoideus  internus  i  Kius.  .^(,-,  a.nl  ."."    is  ^n.ng.r  than  th.  .M.nr.-s,  ^^lll,h  ...n 
,v.ls  its  ...iu'In,  an.l  its  fasciculi  cn.ss  those  ^.l  du    latter  nn.s.l...      It  lak.  s  a  t.ir.K  t.n.hn.-us 
origin  fn.  n  the  i-lervgoi.!  fossa  of  the  spiv.  n..i.l  iK.ne  an.l  passes  h.  the  iiuur  surta..'  .•!  ih.   angle 


m  If  ^ 


1  !' 


184 


ATLAS    AND   TEXT-BOOK   OF    HUMAN    ANATOMY. 


Fk;   266.— The  ilccp  hivcrs  uf  the  faci;il  muscles,  the  buccinator,  and  the  ptervRouls,  seen  from  the  side. 

'  Till-  lowir  puriiun  of  I'hr  nm|».ralis  loKflhtr  with  the  (onmoid  pnxrss  of  the  mandible  has  U'l-n  rcmovod;    the  whole 
of  the  masseier  i^  also  removed  and  the  parotid  duet  has  Ix-en  severed  near  its  entrance  into  the  buccinator. 
Fig.  267.  -The  left  platysma,  seen  from  the  side. 


'  1 

1 

:, 

1 

":    i 

II 


of  the  jaw,  where  it  is  inserted  exactly  opposite  to  the  masscter.     The  outer  surface  of  the  muscle 
is  usually  ajioneurotic. 

(The  ptervRoideus  inlernus  is  an  elevator  <.t  the  mandible,  assisting  the  temporalis  and  m.issotcr.  The  ptcrygoidcus 
cxtcrnus  ilraws  the  eondvie  of  the  man.lil.le  and  the  artiiular  disc  forward  uiM.n  the  articular  eminence;  when  th.  muscle 
of  on.'  sUle  acts  alone,  it  <iraws  forward  the  mandibular  .ondyle  to  whi.  h  it  is  attache.l,  the  other  one  pivojng 
in  the  mandibular  f.>s.sa.  and  the  result  Ining  an  api-arintly  la!<  ,.d  m.ivement  of  the  mandible.— Eo  ] 

The  musdes  are  supplied  by  the  external  and  i.iternal  i.lerygoid  nerves  from  the  third  division  of  the  trigcmuius. 

THE  FASaiE  OF  THE  HEAD. 

The  p,irotUlfo-ma<iSflirk  jascia  (Fig.  260)  is  the  layer  of  fascia  which  passes  over  the 
j.aroli(i  gland  and  the  masseter  muscle.  .\t  the  zygoma  it  is  (onneded  with  the  temiKirul  fascia, 
at  the  anterior  margin  of  the  ma.sseter  with  the  l)Uccopharyiigeai  fascia,  and  at  the  angle  of 
the  jaw  with  the  cervical  fascia. 

The  tcmpor.il  j^isciti  (Figs.  2O0  and  M)J  1  is  th.'  stronge-l  lasria  in  the  head  and  in  ii^  lower 
]K.rtion  divides  into  two  'ayer-.  the  suprrfii  ial  and  llu  -.'../),  whit  h  are  se]iarate(i  hy  fatty  n-sue. 
The  interspace  between  the  twt,  layers  beconii  s  larger  a.  they  (Uscen<l.  the  sui-erficial  layer 
inserting  into  th<'  anterior,  the  deep  iiit"  the  posterior  l)order  of  the  zygoma.     The  upi)er  rir 
cumference  of  the  l.ni]".ral  f.i-<  ia  i^  (onnectr.!  with  the  galea  aponinrnlM  .1. 

The  anterior  i>ortion  of  ihi-  hu^'Opliaryiiiirii/  jum  in  lies  upon  il.e  buo  inab.r  and  is  conn,  rted 
with  the  parotide.,  ni.i-el.ric  fascia;  tlic  ifMcri-.r  portion  is  stronger,  more  i.ndinofo.  .iml 
(overs  the  inner  >urfa<e  .d'  the  pl.ryg.-i.ku>  ini.rnn..  In  ilii^  !,oM,i-i.,r  p<.rli..n  are  .  mU-tMui  ih. 
pt.ryf^onwiiilihul.ir  raplu  ,  pt.rxi^nm.ixilhiry  lii^uninil-  an.t  the  slyl,wu„ulihul,ir  sty'oiiuixillarvi 
lifi.niKitl  (se.  '  ag.  I  iHi.  In  this  Hiuali..n  the  fax  ia  form-  the  poster.,  lateral  «all  of  the  oral 
cavit''  anii  ih>   lateral  wait  of  the  pharynx. 

jTh.    .r..n...i  m,...  uUlure,  .onsi.l.nd  f,-...,  il.,   d.  u  i..pm.  m.il  .t.mdi.o.nl .  in.  hide,  Mveral  m  .-  le-  in  a.j.lili.m  lo 
thos,.  «l.„l.  ..r,  ...MKI1.-.I  toth.'  h.ad  ii,  th.   ..I.,v.'  d.-.  option    -i...  .■  it  .-  proj.rly  to  U-  r,Kar.l..l  as  ,  on.i^tinK  of  all  the 

,„.i..  1.     -.ippl..  d  l.v  ih.  ,  runial  fi.  n.  ■.      \moni;  ll.ev  ...  rvr-  ih.t,- ,  vi,i  m..tor  hln-r^  ..(  H..  .bit.  r.1,1  .,.Mhties     1  1 1  lateral 
„„„„r  r...tv  v>l„.M-n,..l.i.f  ...iain  ,na  ,  I-'  re«.,.d,-d  a- .«  .  u,.^  in«  ..  ,-.-.ti....  ...I.  r..i.-.|ial.-  b.tw.,..  th.  <c^-.r^  .....  I.i  ati.l 

,  ,)  th.-  ....  .Ii..n  nv.t..r  r...tv  vvl.i,  h  ...r..  ^|..ii.t  in  all  th.  ir  e...-nl.aK  t..  !!..■  ...it.  rior  r.„I-  ..f  th.-  S'.»..l  .  ...'I       1  h.   i.il.ral 

m..|...  r..'      "li.  H  ■"'■...  1"  ...nn.-.tion  »vnh  ll..-  I.flh,  MV.-mh,  ninth.  I. mil.  an.j  ,1,  v...ili       rv.,.  ..r,   .li-.i  ilnit.  .1  (..  the 

,„u«a ...i.<l    .viihth.    .mbrv.n..    br.i.i.  hul  ar.  h.  s.  while  the  ......b.,..  .....I...   .....l-  ....    .,  |.r, -.  Ml.  .Ma    llu    thiol. 

(ourtH,  M*.h,  anil  l«.  Ifth  m  rv.-^  and  supple  th,'  mu^ilrs  a-«»  ial..!  «.ll     he  .v.  '.iH  aii.l  tone..^ 

Inai...r.l,.n..-  wilh  ihiMlilT.  r.  m.  ..I  .n.i.rv.itlu...  «hi,  h  i,  o(  gr.  al  i!...rph..l..ui,  al  in.i.irlan.  ih.' .  ranial  m'l-.  iila 
,„„.,„,.  ;.-,|..„i,,l  ..tioovo  Rr..m..  i.i  lli.- iHV...H,vi,  ,,,u-.  I.  s -..pph.-.l  !■>  im-.lian  moP.r  r...t^.  and  { ;l  ih.- /.r.<"./i. 
.m,rr:,   n,u~lt-    -iippi,..!  l-v  lal.-ral  ..■..'••r  r.-.l-       The  mii'«  I.  ••  l..l..n«i.tK  !..  ill.    form,  r  ijn.up  a-  >v.ll  a.  .<i!a..   ..I  lho.-.e 

1.  l..n«ina  t..lh.  bran,  hi i.  «ri.ui..  -u.  h  a*  I...  mux,  I. ,  „f  the  lympamim.  |s-.l..l.  .  pha.  v ..  v  and  larvnv.  w  ill  U-  .1,  m  ril»-.l 

in.l    fiK.."-d    in    ...nm.ti..n    with    ih.     -.  «.o.is   L.    whi,  h  .li.v    U  L.ntf.  but    f.r    ;h.-   ~..k.    -t    •  .......l.ten.  .-  .l..v    w.ll 

(,  i„.  l„.l,.l  i-t  th.   .l.-.t....l....i  .h.U  foll..«^       In  .he.la«-if...,li...iof  Ih.     lu-.  I.  «  .-f  .a.:.   r""M'  H"-   in.bM.hial   nirvt- 

^•ipf.ty  may  i<.»m  ihr  ...i»is. 


m 
I  j  1 1. 


THE   MUSCI.KS  OF   THI.   Xl'PKR   KXTRF.MTTY. 


18  = 


I.   MvOMKUic-  Musci  r.s. 
(„)  The  oculomou.r  mu^v K  ,:  .rtwA.r  /.„//-..V,f  s„<>eri„ris.  rntu,  u.fcrior,  rectus  mnl,„lis.  rn lus  n,,,rior.  .,,,,1  ohliquu. 
inleriitr. 

(b)  The  troililciris  musi  lis;   ohliquus  sut^rriur, 
(()  The  alKhiirn.-.  muscles:    rrciiia  liilcr.ila 

(d)  The  hy|Kigli)ssus  musiles.   frHWc'"""'-  hy^l-"^"^,  slyhqlossiis.  and  liiixu.di':. 

2.     likANCMIOV.KKIC    M  I'SCl.IiS. 

{,•)  The  trigeminus  museles:  m„.wfrr,  lcmpor,:li>,  phryaoidn,^  ,x„r„us.  !,lrryx„i.l,;..<:  Uuenv,^.  myhl  „■   '  .  >.  .'     ■ 
Iricus  (anterior  Ik'IIvI,  Innnr  p.ihi'.i,  an<l  Ifiisor  lymp.ini.  ^ 

(h)  The   facialis   museUs:  \iylohy,>idf,i^.  dig.islnnis   (i»,sUTi..r  lu  llv\   >.l„pnl,i,-<,    t.l.ilysni.i,   ,pi,ra:u.  <     ,„.     ;.•■ 
auricular,  i.alpeliral,  iiral,  and  nasal  nnisclis  as  classilud  alii.c. 

(c)  The  vagc-accessorius  muscles:   „yl.'pl,.,rv„nn.^.  /--v/mr  v,li  p.ilalm.e.  mus.:  ,r.:,l,<:  p.,l.„.n:l„.su-.  ;w/„/,./,/,„rv»- 

geus,  constriclori-s  pharynsn,  the  larNriReul  nius(  les.  trapezius,  an.l  sl,rm,deid„m„slo,dni^.-\:D\ 


THE  MUSCLES  OF  THE  UPPER  EXTREMITY. 

The  muscles  of  the  ujiiar  ixlrtiiiily  arc  comixistd  of  four  cliiif  ,i;rouiis; 

I.  The  muscles  of  the  shoulder,  /.  -.,  nuisdcs  which  ari^'  from  the  .shoultkr-^irdk', 
pass  throui,'h  the  refjion  of  the  slioulder.  an<l  are  inserted  into  the  si<eleton  of  the  free  ui)per 
extremity  in  the  viiinity  of  the  -lioulder  joint.  Tliis  ,c;roui.  inihides  tiie  ,l< !loii!nis,  the  si<l>r,i- 
spinalHS,  the  injrnspiiuitus,  the  tma  minor,  ilie  siiku.i pulnris,  and  llir  i.ns  worn. 

II.  The  muscles  of  the  upper  arm,  ;.  <■.,  nni-iU-  tlie  ,i,'reater  j-ortion  of  wiii.  h  ;ire  Miuaii-d 
in  the  upijer  arm.  'I'his  .'.^roup  is  subdivided  into:  i  i  '  Tlu'  miisvl.'s  of  the  llexor  ~urt:e,e:  u) 
the  muscles  of  the  extensor  surhK  e. 

('.rou])  II,  I,  is  ■■onij.Msrd  of  liie  hi<--h:  br,i,l:it.  tile  lonimhr.n  In.ilis.  and  ih.  hra,hi<ili^: 
grou])  II,  2,  is  forme<l  l>y  die  Iri,,  ps  hrmliii  coul  'lie  •iiKdiini^':. 

III.  The  muscles  of  the  firearm,  ;.  <■.,  liio-e  of  wliiih  the  .i^reater  iioriion-  -re  -iiu.iud 
in  the  forearm.  .\c  cord  in;;  !(■  their  arranu'ennnl  .md  jiosilion  iluy  irc'  cuiii-OMci  oi  tliro  suh 
divisions:  (i)  tlie  miisele^  of  :he  Ik  \or  surlac';  I -'•  the  niustic-  of  ih.'  radi.d  H'ir;  (?;  ihi' 
museks  of  die  (Aiiiisor  suu.m. 

The  nii;.-.k-  .d'    llu    ik  \or    Mirfaee  are  arranged   in   t"o    l.iyers.     Tlu-  sninrluial   iner   i 
foriiitd  iiy  tlie  pronator  /.t.  v,  ih,    p.ilmoris  loii,Ktis,  llu   /.  vor  .nrpi  niili<ili\  ilie  ,A  ^or  .lii^iionim 
siihl::ni>,  and  llir  y/'.vo;-  ,,irpi  uhutris.     The  dee].  la\cr  I-  .omiioscd  of  th'-  jU\or  ,li:'Horiiin  pro 
jitni/-'i,  tlu  ;l(.\i'r  poll.ii-.  loiii^ii^.  and  the  pronalor  ,ji<.,idriUu^. 

The  'adial  '.rroir.  (on-i>ts  of  llir  br,u  liiora'li.ili^,  tlu  i  xU  nu-r  lorl'i  raili.il:^  l,nr^i<\  and 
ihe  I  vtiii^oi-  iiirpi  roiliiil:^  hri'!'^. 

In  tlie  iniisi  le>  nf  llu   ext.ii-    r  ;,roui)  tin    ■.iipinotor  luiM-  a  soec  i.d  posiliiM..     The  remaii> 
ill!,'  nr:sii.-saiv  ,n,ni>osed,  of  ihr...  -uLdiv  i^.m-.     on   A  -.uperli.  i.d  lavrr,  form,  d  1,\  ilu   rMnisor 
,lii^ilon<iii  noMiiiiin;^,  li,.    -  \/.;/  ,'r  /.•■'<//.'   I  proprins,  an-!  'Ju-  '  <!■  ii'^or  <.irpi  iiliiorls.    i /o  a  .h-ej. 


ot,ii,|u-    l;p^  I.  io  :,i.il    .y  iIm-  ■I'.iu  '  ly  /»■'",  .■.  ' '".c»v  and  the  r\:',  i:--or  p:'lli,h  hr^ .  i  ■ 


del  |) 
s!rai:.;ht  lav.  r,  .oinpu^ed  of  llu  .  ylnt^r.r  polli,  .^  lon'^^iis  and  tlu-  .  \l<  in.'r  iiidois  propriu- 

W .  The  musc'es  of  the  hnvA,  i.  -.,  iho-i  wliiih  .  ^'l  nd  h.  iwim  \<i\<-\-  "i  t!u   -ki  l.  H'li  "i 
i'le  IviP.d.      The-.      -vji-.ele-  are  su':di\ide.'   it'.o  tiin  «■  inoiip:-:    (il  The  niusele>  <  I    tlu-   thenar 


m^i^ 


*^*J«Bfel^ii*i*«$ ' 


iZLJf' 


jj,6  ATLAS    AND   TEXTBOOK    OF    HUMAN    .\NATOMY. 

F:r    .68  ^Thc  n^usdcs  „f  the  p...orior  surfac  of  ,he  left  sc.pula  an.l  .he  neighboring  portion  of  the 

TZ^^^:'::^:T::t':::;::^i^^:oi  the  .ft  ..^.a  a„.l  tl.  ne.h,.oring  ^.tion  of  .he 


vt     1 11:1; 

2  ■ 


11 


M    .ho    muscles   of  th.    hviK.ihcnar   eminence;    and    (3)  the    lumbricales    (four) 
(four)  and  the  inhrossci  volarcs  (ihrerV 


THE  MUSCLES  OF  THE  SHOULDER. 
Th  .  deltoideus  Jmrs.  -(,8  and  .70)  is  a  thick,  triangular,  markedly  c.rvcd  muscle  .hich 

wmmmmmm 

tascia  (sLc  iM^i  -"/I.  >  muscle  rau  d  v  diniuushis  in  si/.e  as 

uiiiuT  siirfice  "t   lit    inseiiion   is  mn-cular,    inc    m^h    '^   ' 

ui)l)tr  sur!ai.(.  ui  siibd.  I„,    bursa  (Im-.  26h;. 

th..  fascia  of  which  partlv  cvers  ,..  under  surface,  and  ,hc  in  ,r    ,„.  .r 
Uk.  ,rape.iu>.     It.  .nser,io„  i.  emhrace-l  by  the  orig.n  of  the  brach.ali>. 

Th.    supraspinatus  .Kig.  .oS,  is  a  triangular,  moderately  -7^;-;;';;;;:  \f  tr'!: 

;:;r;:-:zr!zr::;r;;;r:rn^^^^^  


Acromio-clavi 
rulur  tig. 


DeltoUU'its  > 


Subdeltoid  hiir.^ii 


I  cvinor  sritniiltic 

h'/ii'.">l:iniic:is  minor  < 
fh'li'-ii'!-  ■ 

l(/i,^in-ii>idi-i:,  I'Kijor 


Pectcriilii,  major 


<iiM':vi:!S 
Conuoid  /irii'YS-- 

i'litjni'i.i  ii:iiiiif 


'•■■•^.-/isnlis 


Srrratn 
ant.  \ 


llhvns   ■7ri,.-;    itvd) 


t. 


m 


4 

4«< 


I 
I 


I    :.l 


;:|    fcr 


thp:  Mt'sri.r.s  of  tiik.  snori.DKR.  i.Sy 

immcrliiitc'Iv  ht-ncath  the  skin  in  liu'  scajmlar  region  (sic  pa.m'  14(1).  Tlu'  mus(  k-  arises  from  tlu' 
entire  surface  of  tlie  infrasjnnatus  fossa  and  from  the  markedly  a])()neiirolic  enveloi)in,i;  infrasjiin- 
atus  fascia.  The  fibers  are  jiraetically  hori/onlal,  and  as  they  loineri^e  loward  tlie  insertion 
fre(|uently  form  a  kind  of  intermediate  tendon.  Tlie  terminal  tendon  is  a  llat  stroni;  tt'ndon, 
and,  like  that  of  the  sui)ra.spinatus,  is  adherent  to  the  articular  cajisule  of  the  shouliler  joint;  it 
is  inserted  into  the  middle  facet  of  the  greater  tubenle  of  the  humerus. 

Tin-  .suiinis|iitialiis  :iii>l  the  infr.ispin.nus  .in'  suppliiil  hy  llu-  .~ii|ir,i-.i  apiil.ir  iutm.  'I'h.  v  r.it.iir  llir  arm  ..itw.ird 
(baikuaril). 

The  teres  minor  is  an  elongated  (|uadrangu]ar  nniscK-,  situated  immediately  below  the 
infraspinatus,  to  which  it  is  more  or  less  adherent.  It  is  covered  by  the  inlras]iinatus  fascia, 
from  which  it  takes  a  ])artial  origin,  and  in  its  outer  third  ii  is  also  covered  by  the  ileltoideus. 
It  arises  from  the  lower  ])art  of"  the  infrasiiinatus  fossa  and  from  tin'  middle  portion  of  the 
a.xillary  lx)rder  of  the  scajmla.  The  tendon  of  the  muscle  is  but  slightly  narrowed  and  is  inserte<l 
into  the  lowermost  facet  of  the  greater  tubercle,  being,  like  the  tendons  of  the  i)receding  muscles, 
also  adherent  to  the  articular  ca])sule  of  the  shoulder  joint. 

Till-  tiTi's  niinnr  is  .'.iipiilird  l>y  iIk-  axillary  (i  irmnillc* )  nirvi-  an. I  i,  an  ■•Mirnal  Mlatnr  liki-  ill.'  '.ui.ra?|.iTialii-i  and 
ihc  infraspinaui^. 

The  teres  major  (Figs.  268  and  ^(k))  is  stronger  and  longer  than  the  teres  minor.  Its 
origin  is  covereil  by  the  latissimus,  luing  situated  between  this  musde  and  the  teres  minor,  and 
it  lies  along  the  axillary  Ixirder  of  the  scapula  somewhat  nearer  tr  the  dorsal  surface.  It  arises 
from  the  dorsal  surface  of  the  lower  third  of  the  axillary  border  of  the  sca]>ida,  ixtending  iloun 
ward  as  far  as  the  inferior  angle,  and,  (Tossing  the  long  Inad  of  the  triceps,  it  terniinatis  in  a 
broad  thick  tendon  which  is  situated  in  front  of  that  of  the  latissinuis  and  i^  inserted  with  it  into 
the  entire  length  of  the  lesser  tubercular  ridge  (sec  jiage  1.401. 

Iktween  the  teres  major  and  minor  then'  is  a  Iriangidar  a])erlure  whiih  is  sulxlivided  by 
the  long  head  of  the  triceps  into  an  inner  triangular  and  an  outer  (|uadrangular  space.  The 
triangular  sjiace  gives  jiassage  to  the  lircimillix  scapular  artery,  while  the  (|uadrangidar  space 
transmits  the  axillary  nerve  and  the  i)osterior  lirmmllex  arter\  of  the  humerus. 

Tin-  Iin^  Tiiajnr  i-  ^upplird  liy  lllf  .--uIim  aprllar  ihtv."..      ll  i^  an  inlirnd  rntalMr  of  ilu   arm,  a^-i^liiiK  tin-  lali-.-imiis. 

'l"he  subscapularis  iFig.  2(h))  is  a  broad,  llat,  triangular  nniMle  whi.  h  completely  lilb  the 
subscap'dar  fossa.  The  nnisilc  with  its  fast  ia  i^  in  (ontatt  with  the  serralus  anterior  b\  its 
entire  w.Mih,  with  the  origin  of  the  ^hort  head  of  the  biceps  an<l  the  lorat obrachialis  by  its  inser- 
tion, and  with  the  teri's  major  and  the  origin  of  the  long  heacl  of  the  triteps  by  its  lower  l)order. 
The  upper  border  of  the  nniscle  is  adjacent  to  the  origin  n\  the  onioliMiid. 

It  arises  from  the  subscapular  fossa  an<i  from  the  nuisndar  line>  ihiri'on.  Its  f;(sriiuli 
converge  to  a  numlHT  of  intermuscular  sepia,  and  the  stri>ng  broad  t  ■Md"n  o(  ins(  riion  pa--Ms 
over  the  anterior  surface  of  the  artiiiilar  (a])sule  of  the  shoulder  joiiii,  lo  uhi(li  ii  is  lirndy 
adheren',  and  is  attached  to  the  lesser  tulKrile  of  the  hunttrus  and  lo  the  mighltoring  portion 
of  the  Icssi  r  tubtreular  ridge. 


<  <l 


0' 

I 


..-.Mf- 


■\m 


n  I 


1 88 


ATLAS    AND   TKXT-BOOK    OF   HUMAN    ANATOMY. 


Fig.  270.— The  deltoid  and  muscles  of  the  upper  arm  seen  from  the  side. 

Fic.  271.— The  muscles  of  the  upper  arm  seen  from  the  side  and  from  liehind. 
Tin-  iiart  i.|  \hv  ;intih™  hial  f.is.  iu  whirh  lov.rs  the  an<i>ncus  has  lifin  rfmovt-ii  and  thi-  ouUr  h.ad  of  Uu-  Iriiciw 
has  lirin  stviri-d  and  turned  aside  in  either  direilinn. 

Flc.  272.— The  muscles  of  the  flexor  surface  of  the  up[)er  arm,  superficial  layer. 
The  deltoid  has  Uen  removed. 

Fu;.  273.— The  muscles  of  the  tle.xor  surface  of  the  upper  arm,  deep  layer. 
The  deltoid  and  hiieps  have  l)een  removed. 


Immediately  below  the  coracoid  jiroccss,  and  on  the  under  surface  of  the  suhscapularis 
near  its  insertion,  ihere  is  a  constant  bursa  which  is  a  diverticuhim  of  the  synovial  membrane  of 
the  shoulder- joii-    and  is  known  as  the  suhscapiilnr  bursa  (see  page  121). 

e  suhseapularis  i-  sui-plied   l.y  the  subscaimlar  nerves  from  the  brachial  plexus.     It  is  an  internal  rotatornf 


The  sul)scai 
the  arm. 


THE  MUSCLES  OF  THE  UPPER  ARM. 
THE  MUSCLES  OF  THE  FLEXOR  SURFACE. 

Ujion  either  side  of  the  lower  \wn\on  oi  the  arm  there  is  a  distinct  intermuscular  srplurt 
(Figs.  270  to  27,^)  Vtween  the  mus( '  s  of  the  llexor  and  tho.se  of  the  extensor  surface.  The 
internal  intvrmusnitar  st  jilum  is  the  stronoer  of  the  two  and  ends  ;  •  the  internal  ei)icondyle, 
the  external  intermuscular  septum  is  weaker  antl  extends  downward  as  far  as  the  external  epicon- 
dvle.  These  -ejna  give  oiit^in  to  muscles  of  boiii  groujis,  the  external  seiitum  fumisiiing  attach- 
ment also  foi    lie  radial  tiruup. 

'\'hv  biceps  iFigs.  272  and  27;,!  is  a  lonij,  larj,'e,  si)indle  shaped  muscle  which  is  situated 
immedialelv  l)eneath  tiie  brachial  fast  ia  in  (he  anterior  braihial  and  cubital  re:.iioiis,  and  ari.ses 
hy  two  distinct  heads,  the  loni;  head  and  the  siiorl  head.  The  long  head  arises  from  liie  sujiragle- 
noi.lal  tulRTosiiv  of  llie  s,  ajmla  by  means  <>l  a  loiiir  «ylindri.al  tendon,  whi.  li  jiasses  through 
the  cavitv  of  the  siioidd.r  joint  isec  page  121  1  and  thrniigii  the  inttTtubercular  groow,  Ining 
enviloi)ed  in  llie  latter  siui.-njon  by  the  inlerliil"  niilar  muioiis  sludtli  1  F  ig.  27.O.  'I"he  irndon 
of  liie  short  head  is  -horl.  ilai,  and  adherent  !<>  that  <d"  ihc  ,  oracobradiialis;  it  (oines  from  the 
coracoiil  jinKiss  of  tile  scapul.i. 

Kaili  hea.i  of  the  bitcps  forms  a  (  vlindrical  miisctdar  ixHv  iihe  sji,,,-!  iicn!  ainK-t  i.i;medi 
alely  afur  its  oiigini  and  tiie  Iw"  Ixilirs  may  remain  sepiiaied  for  <|uilc  a  di-lame.  t'  ''Mgli  in 
immediale  (onUict  will)  one  another,  lait  always  unite  alH.ve  the  ell)ow  joint  (n.ver  before  uath- 
ing  the  niiildle  of  the  arm  1  to  form  a  single  muscle.  The  widest  part  of  this  muscle  is  at  the 
middle  of  ihe  arm;  and  m  either  side  of  il  a  disiiiul  gr(M,\e  may  be  recogni/.ed,  t!ie  iiiirrnal 
and  external  lueipilal  i^roon^.  .\s  ii  passes  downward,  ihe  mus<ie  becomes  narrower,  and  in 
the  region  of  the  ellxiw  joint  il  passes  into  a  lendoii  of  inst  rtion  whith  i.msists  (f  two  ]K.rlion-, 
I  .1.,     .- . I...-   1  ..  ii,;..  .,i,,,.kI",,  ;  i1   i.i>rti,.ii   l.niiun  tis  lUi'  liKirliis   iiliriiMis  iFiu-. 

a    >'i.-ep,  il.:i .  -t:--:-^    n:;M--Ti    ^i-jm,.    •■■.••    -■;« ; 

2-2,  2"^  27,},  a  .d  2()i  ).      I'lie  latttr  i>  (i)m)K).sed  of  superiiiial  nidiating  lil)t  rs  from  the  lendfii 


Trapezius 


.'i     Hxlernal 
epiconriyle 

(ilfrran?n 


Outer 

head  ■ 


t.xtfrniti  intrr- 


Braehioraiiiiilis 


ixten^or  carpi 
radtalis  loriffus 


I  xtermil 

e/iirondyle 

t.xtinscr  turpi 
rudialis  hrei'is 


t. 


Fig.  270. 


nf>.  271. 


Oniohyoideus  x 


Coracoid 
process. 


Internal 

intermuscular 

septum 


% 
Lmfrtiis  V*' 
/ihrostts 

Antibrachiat 
fascia 


Deltoideus 


Supra- 
spinatus 


Coracobrachialis 


Tendon  of  long 
head  of  bleeps 

ifiursa  of  Idtisslmus 
Tendon  of  latissimus 
Tendon  of 
xioralls  major 


Coraco- 
brachialls 


htleriiid 

inif-niiseular 

septum 


Internal 
epieondyle 


lendon  if  bleeps 


braehii 


Coracoctavi- 
'r-"^     ndarltg. 

Coraco-acro- 
mleil  llg- 


Intertnhereutar 
miieons  sheath 


lenUin  of  hice:)S 
(lonii  lieod) 


Tendon  of 
■torahs  major 


oni;  head 
of  biceps  ■ 


I  aeerlns 

llieipilii-radlal 
tnirsti 

I  eiidon 
bleeps 


fig.  272. 


H^.  271. 


F II 


i.  I:= 


i^ 


THE   miSCI.KS   OF   THT-.  TU'PKR   ARM. 


iS() 


i  i 


of  the  biceps,  which  pass  obliquely  across  the  antecubital  fossa  toward  the  ulnar    suU     uvl 
fade  away    n  \hv  antibrachial  fascia  covering  the  supertkial  llexors  ol  the  lorearm. 
mi  tendon  of  the  biceps  .uscle  passes  deep  down  bc^een  the  .lexo^and  U,e  r.  uU 
croups  of  muscles  an<l  inserts  into  the  tuberosity  of  the  rad.us  (P,,s.  .7,^  -".1     ,0.      lUt  u  n 
r  til  of  insertion  and  the  radius  there  is  place.l  a  bursa,  the  l>,at>.>or,ui.al  bursa    ,!•,«. 

,vith  .h.-  su,.inu,or  bn-vis).  an.l  iP..r.as,.s  ihc-  .cn.,,.,     o,  .lu-  :uu,l,r.,  h  ,  1  f.,-  A    h,„l 

i.  ,,rc.s.nt  in  ran-  instanus;   i.  aris.-s  from  .ho  hun.-n,.  u,  ,  ..n,m.,n  w,.H    .„   hr,„  h.,.,,. 

The  coracobrachialis  (Fis.  273)  is  a  Ion,  and  rather  Hat  muscle,  which  i.  placed  alon.si.l.. 
of  th    short  head  of  the  biceps  and  is  almost  entirely  conceale.l  by  th,s  structure.     1  >  >lor 
tencU  n     f  origin,  arisin,  from  the  tip  of  the  coracoid  process,  is  adherent  to  jh.  short  head  o 
TZ.,s  an^    overs  ^e  insertion  of  the  subscapularis  and  the  ten  on>  o,  the  la„sMmus  an. 
te re     n  ajor   shortlv   before    their   insertion.      It    is   inserted   into    th.    antenor    and    m  ernal 
uHaces    ,f  the  humerus  at  about  its  mi.Uile,  below  the  lesser  tubercu  ar  rul.e,  and  m  0    he 
internal  intermuscular  septum.     The  muscle  possesses  a  Ion,  slit  wh.ch  g.ves  passage  to  the 
musculocutanious  nerve. 


Tin-  .  ora.  ol,ra<  hi.ilisi>  Miiiplio'l  ''X  tlu-  musi  ul.KUlam-.ms  n.TW, 


II  cl^'vati's  tin-  upiKT  arm.  as>islinK  the  ck-llimlius. 


The  brachialis  (Fi,s.  273  to  27?)  is  a  stron,,  broad,  rather  Hat,  elongated  muscle,  almost 
cntirelv  concealed  bv  .he  biceps,  whi,  h  is  situate.l  in  the  lower  two  th.rds  o,  the  tlexor  surlace 
of  the' arm.  It  arises  from  the  antero-internal  surface  ot  .e  humerus,  somewhat  abo...  the 
middle  of  the  b<,ne  and,  embracing  the  insertion  of  the  -leltoid,  take.  on,u,  al.,  Irom  the  an  ero- 
internal  and  antero-ex.ernal  surfaces  of  the  lower  portion  .  f  the  .halt  o,  the  hun,eru.   and  f    n 

he  internal  and  external  intermuscular  septa,  the  origin  from  .he  .nternahn.ernu>scular  scp  urn 
extending  .lownward  aln.ost  to  the  internal  condyle.     The  amerior  surfac.  o     the  nu.cle  . 

distinctlv  hollowed  to  accommodate  the  overlyin,  bice,,s,  and  m  .Ije  lower  ,.ornon  of  .he  .rn 
app..ars  ,0  either  .ide  of  .ha.  muscle.     ( )n  .he  ou.er  side  i.  is  in  rela.-on  wuh  .he  ou.er  head  of 

he  triceps  and  with  .he  brachiora.iialis;  on  .he  intter  side,  it  isespecially  d.s.u.ct  and  ,s  „,  relat.on 

with  the  inner  head  of  .he  triceps.     1.  is  inserted  into  the  tulxTosity  o,  .he-  ulna  by  mean,  of  a 

strong  .en<lon  which  is  especially  well  d.velope.l  upon  the  anter.or  surface  ot  the  muse  e.      1. 

iLnion  is  concealed  by  .lie  .endon  of  .he  biceps  and  also  by  the  superhc.al  ilexors  of  the  forearm 

arising  from  the  internal  condyle. 

Tlu-  l,ra,!uaUs  is  supplicl  by  ,he  musculoru.an.ou.  nor^•>.  and  usually  also  by  tbc  ra.lial.     It  i,  a  pure  flow  of  .Ik- 
forearm. 


THE  MUSCLES  OF  THE  EXTENSOR  St^FACE. 
The  triceps  (Figs.  268  and  270  .0  27.^)  is  a  larg..  elonu       I  muscl,   wl 


hich  ]iossesses  .liree 
hcad^  T^^h,>:-hr-u!  'anamrus  h'K^us)  (Figs.  268  and  27.  .0  27.^)  is  a  somewhat  roun.lal 
muscle  which  arises  bv  a  short  tendon  from  .he  infraglenoi.lal  tuberosi.v  of  he  ^_';M'ula.  It 
passes  iK'lween  the  teres  major  and  minor,  that  is  to  .say,  in  fron.  of  .he  lere.  mn.or  an-l  beh.nd  the 


IQO 


ATLAS    AND   TEXT-BOOK    OF   HUMAN    ANATOMY. 


■'I 


teres  major  (sec  page  187),  and  becomes  aponeurotic  u])on  its  inner  surface.     It  is  frequently 
connected  with  the  latissimus  dorsi  by  a  tendinous  slip. 

The  oulcr  head  (anconeus  lateralis)  (Figs.  270  and  271)  arises  from  the  iMistero-external 
surfac  I  01"  the  humerus,  commencing  immediately  below  the  greater  tubercle,  and  from  the  upper 
half  c  ■  the  upper  two-th-'nls  of  the  external  intermuscular  sejitum.  The  origin  of  this  outer 
head  is  librou^  above  but  fleshy  below;  its  libers  run  downward  and  inward  to  the  common 
tendon  of  the  tricejjs. 

The  inner  head  (anconeus  medial  is)  (Figs.  271  to  2;;,)  arises  more  deeply  than  the  outer  one, 
and  its  fibers  are  shorter  and  extend  further  downward;  a:,  a  rule,  however,  it  is  not  as  strong 
as  the  outer  head.  It  arises  fro.ii  the  entire  length  of  the  internal  intermuscular  s'jptum,  opposite 
to  the  brachialis  and  i)artly  covered  by  the  biceps,  from  the  posterior  surface  of  the  humerus 
below  the  groove  fo  •  radial  nerve,  and  from  th.  i-xternal  intermuscular  septum  as  low  down 
as  the  external  epicondy  le.  The  j)ortion  of  it  which  jomes  from  the  internal  intermuscular  septum 
and  which  is  not  concealed  by  the  biceps,  lies  immediately  beneath  the  brachial  fascia,  as  does 
also  that  portion  arising  from  the  external  intermuscular  septum,  which  is  not  covered  by  the  outer 
head.  A  large  i«rt  of  the  inner  liead  is  concealed  by  the  outer  one,  and  between  the  origins  of 
the  inner  and  outer  heads  the  radial  nerve  runs  in  its  groove. 

The  fibers  of  the  inner  and  outer  heads  unite  with  those  of  the  long  head  and  pass  into  the 
common  extensor  tendon,  which  commences  upon  the  j)osterior  surface  of  the  muscle  at  about 
the  middle  of  the  arm  and  is  inserted  chicly  into  the  olecranon  pr.  ,ess  of  the  ulna.  The  insertion 
not  only  completely  surrounds  the  olecranon,  but  also  radiates  to  the  ulna  and  the  a..tibrachial 
fascia. 

The  triceps  occu])ies  the  entire  extensor  surface  of  'he  arm  l)etueen  the  intermuscular  >epta, 
and  is  conse(|uently  situated  in  the  po.stenxAternal  and  [)ostero-internal  irachia'  regions.  The 
relations  of  the  long  head  have  already  been  described  (-ee  page  1871.  The  inner  head  is  in 
relation  with  the  brachialis  at  the  internal  intermuscular  septum,  and  at  the  internal  epicondyle 
its  fil)ers  are  C(mtinued  directly  into  the  anconeus;  the  outer  head,  at  the  external  intermuscular 
septum,  is  in  relation  successixely  with  the  brachialis,  the  brachioradialis,  and  sometimes  also 
with  the  extensor  carpi  radiali^  longus. 

Till-  triccp-  i^  v(i|i|,li,.,l  l.y  the  ni<iial  lurvi-.      Il  i-\ti'nil-  ihr  f"rcarm. 

I'rom  a  functional  and  toj^ographic  standpoint  the  triceps  is  associated  with  the  anconeus 
(anconeus  quarlus)  (Figs.  271,  278,  and  2S0),  which  is  situated  in  the  up])er  jjar'  of  the  forearm, 
and  is  a  llat  triangular  muscle  lying  l-mcath  but  not  adherent  to  l\w  antibrachial  fascia.  The 
lower  angle  of  the  muscle  is  jjlaced  tx'tween  the  tleXi)r  carjii  ulnaris  and  the  suinrlicial  grouj)  of 
extensors.  It  arises  1  ,  ■>  -hort  tendon  from  the  external  epicondyle,  passes  over  the  articular 
capsule  of  the  ellK)w  joint,  to  uhii  h  il  is  adherent,  and  is  inserted  into  the  upper  portion  of  the 
posterior  surface  of  the  ulna  immediately  below  the  olecranon.  The  ujjjjcr  libers  of  the  muscle 
are  usually  directly  continuous  with  the  lower  ])onion  of  the  inner  head  of  the  trice 

Tlu'  ancum-iis  has  a  funiticm  ami  innervation  Mniilar  to  that  of  the  Iric'ii^,  an. I  in  ad.lilion  it  m.  rcasi-s  the  tension 
■it  the  artirular  eapsnle  .if  the  ell),)w-ioint.  Th.n-  is  f,r,|„enlly  a  small  rnnsrular  fas,  i,  iilus  passing  between  the  internal 
epicondyle  and  the  olecranon  over  the  iiln.ir  nerve;   il  i-  known  as  the  epilroihlco-aiiconcus. 


THK   MUSCLES   OH    TlIK   FOREARM. 


191 


!i 


THE  MUSCLES  OF  THE  FOREARM. 
THE  MUSCLES  OF  THE  FLEXOR  SURFACE 

THE  SUPERFICIAL  LAYER. 

The  superficial  layer  of  the  flexor  firoup  (FiK-  274)  consists  of  a  muscle  complex  which 
arises  by  a  common  tendon  from  the  internal  e])iconflyle.  All  of  the  muscles  of  this  grouj)  with 
the  exception  of  the  jjronator  teres  pas.;  beyond  the  wrist  joint  and  become  tendinous  at  a  varying 
distance  alxne  this  articulation,  and  they  occupy  the  ulnar  side  of  the  volar  surface  of 
the  forearm.  In  the  u  per  portion  of  the  forearm  they  are  all  adherent  to  the  antibrachial 
fascia,  with  the  excejition  of  the  Ikxor  digitorum  sublimis,  and  conceal  the  insertii)n  of 
the  brachialis.  They  are  sepii-  itid  from  the  radial  grou])  of  muscles  by  a  deep  groove 
through  which  the  tendon  of  tht  .lu  ^  passes  to  its  insertion  (see  page  188),  and  in  contrail 
to  the  muscles  of  the  dei      'n.r  tlu  y  ;n  :>e  cli    'ly  in  the  upper  arm  and,  with  the  e.xce-plion  of  the 

ilations. 

he  ('   termost  of  the  grou]),  is  an  elongated  quad- 

rhe  hmmral  head  is  the  stronger  and  comes  from 

u  nor  head  x-.  more  deei)ly  ])laced,  coming  from  the 

Ihen  he  tendon  of  the  brachialis.     The 

'lan  lUTM. 

ions  of  the  bice])s  and  su])in:'      ■  and  ])asses 
ariace  of  the  radius,  \>here        -  attached  to 


!    \'<) 


pronator  teres,  consequ     tly  |)ass  1 

The  pronator  teics  (Figs.  2;  ,  and 
rai  gular  muscle  which  arises  by  tw.-  b.i  ad 
the  common  tendon  of  origii^;   the     ni-.. 
ct)ronoid  pnKess  of  the  ulna,  and  is  la-tp 
s])ace  between  the  two  hea  is  gU'es  passa;. 

The  Ix'Uy  of  the  i)r')nator  tea-  covei 
below  the  latter  musile  to  the  middle  of  i. 
the  bone  by  a  short  tendon  (Fig.  2S0). 

This  musi  If.  liki'  tlu-  majority  of  \\u-  -luuii,  i-  -uinii: 
the  foaarni,  and  it  lan  also  assi-t  ih.-  brai  hiahs  in  ll.-'  ■  H" 

Usually  gives  a  |Mrii;,l  origin  lo  the  tmisiU'. 

The  flexor  carpi  radialis  irmlialis  im mi, 
the  distal  half  of  which  is  ien<linoas.     It  is  tlie 
radial  to  the  ulnar  side,  and  arises  like  il-.  fell" 
anliljrachial  fascia.     In  the  middle  of  the  forearm 
a  special  .-heath  (see  ])age  205)  benealli   the   trans\ 
multangulum  majus  to  the  lia-e  of  the  .second,  and  son 


ih. 


~uii|ilii'(l  by  llu'  nu'clian  lurvr.     T.igillur  with  ti; 
ill  cMensi'-s  il  i.iu-i'S  r.iiiial  llr^imi  i  radial  aluh 


The  mil-..  1 
it  ails  with  the  i.- 

The  palmaris  longus  (Fig.  274)  is  the  -mallest  :i 
layer,  and  is  w.ak,  freipiently  absent,  and  tendinou- 
origin  is  adherent  to  those  of  its  neighbors  and  is  from 
fascia.     The  long  tendon  becomes  markedly  flatten*  <! 
situated  immediately  beneath  the  fascia;   it  pa.sses  o 
it  is  partly  adherent,  and  radiates  into  the  i)almar  ai 


This   m 


usili-    ail-    ihiilly    as    a    tensor   of    the    |..ilmar    and    .)(    the    .mliiira. 


tn.di.in  mrve.      \-  indirateil  liy  its  name,  it  pronatrs 
,,         int.      Il  a  >uiiraiundyloi(l  proeess  W  present,  it 


Spindle-shaped  muscle, 
group  pas.^ing  from  the 
'  lend'm  an'!  from  the 
.  vhich  pa.s-i  -  through 
the  gi'^ve  n!  the 
iird  nulai  ,;r])al  bone. 

'-oduiis  vol  \ion  ;   \\hen 

,il  muscl.  of  'he  enlire 
f  il-  t o!  rsc.      Its 
he  aniil)r:n  hial 
10 rearm       (I  is 
:;;,riienl,  to  uhich 

lan    al>o    assist    in 


pleolii 

li.  ■■■r  {hv 

le  trai     -  erse  i . 

urosis  (se     ]iagi 


flexing  the  forearm.      It  is  -upi'lied  liy  the  median  nerve. 


192 


ATI.AS    AND    TEXT  HOOK    OF    IIIMAN    .\NATOMY. 


Fi(..  274.  —The  superficial  layer  of  the  museles  of  the  llexor  -urface  o    the  '    Airm  together  with  the 

liraehioradialis,  seen  from  in  fnirit. 
Flc.  275.— The  superficial  liver  of  the  tnu-cies  of  the  llex<ir  surface  of  the  forearm  after  removal  of  the 

palmaris  loi'igus  and  the  tlexor  carpi  railialis,  seen   from  in   'Vont  and  >iightly  from 

the  radial  side. 
Thi-  hrachiurailiulis  is  drawn  oulwuril  to  show  the  su|iinalur  ami  llif  insertion  of  tin-  len.,.m  of  the  tjicrps. 


lUl 


m-- 


The  flexor  digitorum  sublimis  1  Im^s.  274  to  276)  is  tonceakd  at  its  oriirin  by  the  ],alm;tris 
longusand  the  tk'xor  cari.i  radialis,  and  ihc  greater  portion  of  its  ulnar  lx)i(kT  is  c'()'erj(i  by  the 
flexor  caq)i  ulnaris.  The  main  origin  of  the  muscle,  the  humeral  head,  forms  the  deei)est  ])ortion 
of  the  common  tendon  arising  from  the  internal  e])icon(lyle,  while  the  second  heat,  he  radial 
head,  arises  by  a  llat  ti  idon  from  the  volar  surface  an<l  Ixirder  of  the  radius  below  the  in.sertion 
of  the  supinator.  The  two  heads  ate  connected  by  a  tendinous  arch  beneath  which  jiasse.-  uie 
median  nerve,  and  unite  to  form  a  broad  and  strong  muscular  belly  which  is  usually  com  '-*o 
of  two  distinct  portions,  a  superficial  and  a  decj).  The  deep  ])orli()n  receives  t'-r  oblicpie  •  '  ci-, 
from  the  radius  and  soon  gives  olT  the  tendons  forthc  index  and  little  fingers,  \vl,  'le  ten(i;>n:  1  <r 
the  middle  and  ring  fingers  proceed  from  the  sujierf  1  jiortion.  The  four  lendons,  which 
frequently  do  not  become  independent  until  near  the  wrist-joint,  run  through  a  synovial  sheath 
together  with  the  tendons  of  the  deep  tkxor  and  i)ass  beneath  the  transverse  carjjal  ligament 
to  the  middle  ])halanges  of  the  second  to  the  fifth  lingers  (see  page  203). 


Thr  ill  \cir  iliKiloruni  svililin;! 
{our  lin^iT-.. 


i-  ("cilusiviiy  sup|ilir(l  l.y  tlic  nii'ili.m  ncrvr.      It  lUvvrs  tin-  miciillc  [ihalanm  ■;  of  tlir 


The  flexor  carpi  ulnaris  mhiaris  iiilcruii.s]  (Fiixs.  274  and  276)  is  the  innermost  and  the 
most  ])Osterior  muscle  of  the  group.  Its  jxisterior  border  is  in  relation  with  the  an(Oneus  and 
the  su])erlicial  extensors,  being  sejuirated  from  the  latter  by  the  dorsal  border  of  the  ulna.  In 
addition  to  a  humiral  head  liie  muscle  also  posses- s  an  ulnar  head  from  the  anterior  ..rface 
of  the  olecranon,  the  ulnar  nerve  ]MSsing  between  the  two  heads.  .\n  additional  origin  is 
furnished  by  the  a  itibracliial  fascia,  which  is  adherent  to  the  ujijier  two-thirds  of  the  ulnar 
border  of  the  muscle  and  in  means  of  which  the  muscle  arises  from  the  volar  Ijorder  of  the  ulna. 
The  muscle  is  distinctly  semipenniform  in  structure,  since  a  tendon  is  formed  in  its  inner  Ijorder 
at  the  middle  of  the  forearm,  into  which  muscular  fibers  radiate  almost  as  far  down  as  the 
wrist  joint.  This  tendon  is  inserted  into  the  ])isiform  IxJiie  and  the  insertion  is  thence  jirolonged 
to  the  metacar])us  by  the  ligaments  of  the  |)isiform  bone  (see  ])age  125). 

The  miisrlr  i-  >iiii;'lii<l  liy  thi  ulnar  ncrvi.  Wlirn  a<  lin^  with  the  llexor  carpi  ratliali-  it  ctTcils  volar  flexion, 
togclhrr  with  the  cNtmsor  <  arpi  ulnaris  it  prmluii'^  vilnar  flexion. 


THE  DEEP  LAYER. 

The  deep  layer  of  the  muscles  of  the  tlexor  surface  -insists  of  the  two  dee])  flexors  of  the 
diL'its  and  of  the  pronator  ouadratus.     It  is  almost  entirely  concealed  by  ilie  suiierticiid  hiver. 

The  flexor  digitorum  profundus  (Figs.  273  and  277)  is  a  broad,  strong,  thick  muscle 
which  arises  from  the  volar  surface  of  the  ulna  from  the  coionoid  process  to  ti.e  junction  of  the 


iceps  (inner  head) 


Initrnal 
intermiiscu- 
hir  septum 

Intenidl  epirondyle  ...!j 
Olecranon 


scla 


laidon  pf 
bittps 

Pivihiror  l^res 

l.ii  rrtiis 
nbro^i": 


Interna  I 
ipicoi'dyle 


fnlrnan^ 


iXi: 


lirnchio- 
rodi'iiUi 

f'xtrnsor  carpi 
(idiiii'is  lonf^is 
firffiHi  of  biap. 

Hinptio-riiJiiil 
blirs/l 


l-f^M 


ri.vnr  mr}\ 
iilniins 


l(adius 


t'texor  digito-- 
ntm   sublimis 


Fig.  274. 


Flexor  pollicis 
longus 


Tendon  of 
brachioradialis 

Pronator 
i/uadratus 


I 


lendon  of    '■'  f 
palmaris  lo.,gust 


■  Flexor  digitorum 
pro/undu.-< 

Flexor  pollicis 
longits 


Radin<. 
Abductor  pollicis 

longus 
Tendon  of  hrnrliio- 
radialis 

f'rotiiitor 
i    qiiailralii-. 

lendon  of  flexor 
carpi  radialis 


A 


s. , 


Fig.  275. 


flOi 


I 


ih 


fU 


I 


m 


iii 


i^Bji 


THE   MUSCLICS   OF  THE   lOREAP" 


193 


Internal  cpimndylc  ' 


Humeral  head  tij  flexor  sublimis 
dif^itorum 


hlexxr  curl"  iilnari 


Vliuir  hr.id  nj  pmnnl'tr  lere%  X 
Tendon  oj  lorcp-:  X 

SiipiniUor 
lirncliior.idiolis 


K.idiol  hind  oj  fhwir  suhlimis 
dif^ilorum 


!■!•  .\,'r  f'oUiii^  loneus 


I 


.     ,.       ,, ;  ...li  .ii_    .)„    n:ilni.iri-  l..lli!U«.  .Itlcl  111'    l'l"I    l'"r 

FlO.  J7fi.— 'Ihi  lii'ior  suiiiiim^  ilinii'uuni  .ill. ;  1.  ;r..-.vr.:  t^  tnt   .r  t :••  ■■ 


13 


1W\ 


194 


ATLAS   AND   TKXT-BOOK    OF   HUMAN   ANATOMY. 


Flc.  277. — The  deep  Kiyer  of  the  muscles  of  the  llexor  surface  of  the  forearm  after  removal  of  the 

suj)erticial  layer,  seen  from  in  front. 
Fli;.  278,— The  muscles  of  the  forearm  seen  from  the  radial  side. 


rniddle  and  lower  thirds  of  the  Ixme,  and  fiom  the  adjacent  jxirtion  of  the  interosseous  membrane. 
1  r  parallel  tendons  are  soon  jjiven  off,  the  one  situated  nearest  to  the  radial  side  coming  from 
a  separate  muscular  belly  composed  of  the  libers  proceeding  from  the  interosseous  membrane. 
These  tendons  run  in  the  sanu  synovial  sheath  as  do  those  of  the  tlexor  sublimis  and  i)ass  Ivneath 
the  trans\er:e  carpal  ligament  (the  anterior  annular  ligament)  to  terminate  upon  the  ungual 
phalanges  of  the  second  to  the  fifth  lingers  (see  l)age  205). 

Thr  ulrvir  h.ilf  of  till-  mu^ili-  i>  .sujii>lii'(l  In  iln-  ulnar  niTvi-,  the  radial  li.ilf  )iy  iho  median  nrrvc.  It  ttvxvs  llu- 
li-rminal  plialaiiK^s  .if  tlii    four  Iuikits. 

The  flexor  pollicis  longus  (Figs.  275  to  277)  is  a  spindli  shajied  muscle  placed  imme- 
diatelv  alongside  of  the  ilcxor  digilorum  profundis;  it  is  penniform  above  and  semipenniform 
Ixlo" .  It  ariMs  from  ihc  volar  surface  of  the  radius  between  tl'.e  ins.rlion  of  the  supinator 
and  the  upper  border  of  the  pronator  (luadratus.  It  also  usually  receives  a  >lender  fasciculus, 
fre(|uentlv  a]>onein'otii  ,  from  the  coronoid  process  and  from  the  internal  condyle;  this  origin, 
howev(  ',  whi(  h.  is  known  a>  tin-  Itlinuriil  luail.  does  not  come  direcllx  Horn  the  boiv  but  from  the 
muscul  mass  of  the  superlnial  tiexors.  Tlu  nuiscle  bi'comi's  tendinous  almo,~l  imnudialely 
Ix'low  i;-  origin,  the  upjier  portion  receixing  the  muscular  libers  from  either  ^idi'.  the  lower  portion 
from  ilie  radial  ^ide  only,  and  the  tendon  run>  in  il--  own  tendon  -<heatli  iMiicaih  the  lrans\-erse 
carjial  liganienl  and  pa-M's  between  tin-  two  heads  of  the  llc\or  pollicis  bri\i>  to  the  ungual 
])halanx  of  the  thumb. 


Ihr 


'1  In-  ihr  nu-dian  rn'r\r.      h  tlrxt^  tin'  trr!iiinal  |'liaian\  of  thi   ihurut' 


The  pronator  quadratus  .(■'igs.  277  aid  2S11  i>  :i  ll.-it  (juadrilateral  niu-rle  wliidi  i-  con- 
cealed b\  all  ill,  t.  iidon^  id'  the  lliAor  mu>i  Ks  and  lie^  r.pon  llie  volar  surfair^  id'  bolh  bone>  o| 
the  forearm  inward  llu  ir  di-lal  exlrrmitii^.  It  arises  from  llu  volar  border  of  llie  ulna  and 
is  inserted  into  llir  volar  sindai  e  ami  Imrdt;  of  the  radium,  ImiIi  ii>  (uigiii  and  insertion  being 
Usual!;.  b\  short  ,i]  •  neuroses. 


Till'  niusi  il   i-  -ii]i|iliid  ii\  ih.'  11;.  dijn  lurvi 


id  pronali  -  ilii'  foriarm. 


i 


THE  RADIAL  GROUP  OF  THE  MUSCLES  OF  THE  FOREARM. 

'I"he  ihrir  musi  II  s  of  the  radial  group  are  jilaied  at  the  radial  -ide  of  the  forearm  and  of 
llir  loner  |Mirlion  id  llu'  .11111  in  llu'  so  (ailed  r.nli.il  teuinii.  belvvetii  liii  (li  Vuis  ,uiil  llu  evteiisors. 
The  brai  hioradialis  belongs  more  to  the  llexor  surfaic,  but  the  other  ivvo  must  les  are  upon  the 
extensor  side  of  ihe  fort  arm,  and  vvhilt  the  supenk  iai  la\t  rs  of  bolh  tlexor  and  extenx  r  must  les  are 
ii: !  lii-riiU  li!  ll'.i-  fjisti.i  of  lilt'  forearm,  ihe  extensor  ■.  art.!  radialis  lirevis  is  the  oidv  p.lusi  le  i>f  the 
radial  group  in  vvhiih  a  similar  nlalion  obtains. 

The  brachioradialis  iuipniiilor  li'ii^^its)  <Fig>.  270,  271,  and  27  j  to  :->))  is  a  very  long  tlat 


Palmaris  longus 
Pronator  teres 
(humeral  head)  + 
Flexor  carpi  radialis 
Ulnar  head' 
of  pronator  teres 

Tendon  of  biceps  ' 
Humeral  head  of  -' 
flexor  longus  polticis 


Brachioradialis 


Bicipito-radial  bursa 


Fendon  of  fit 
carpi  ii/nans 


Tendons  of  flex.  dig.  suhlimn'^ 


I'ronatoi  teres 


liraihioradialis 
Interosseous  membrane 


I'enu'on  of  bnicbii'tadinlis 


u 


\hducl0: 
lendonofeu.-nsor    pMcis  lonpis 
'  earpi  mdial.  i"nnus     FMcn.wr pnllicis 
hrevis 
fendon 
I  endon  onlexor        "/■  '>^trns.  ,.         ..        ,      . 

r.irni  nidi  il>y     f"'r'  '"«<'•  '<^"g:-  t>ars„f  /   rnrpom 

mamh 


1  Fxternal 

epirondyle         g 

•  Olecranon 


I  \tensor  dig.  V 
propr. 


1,1 


l.ndi'U  of  extens. 

<//(;.  comm. 
tendon  of  extensor 

,/;tf.  t'  propr. 
lei'.don  of  extens 

I  lit  pi  iilnaris 
t  iiiii 


tendon  of  palmaris  lonpus 

lit;  277. 


tindoii  of  extens. 
carpi  rnd.  i>r 


teniioit  I 
h/i:.  27H. 


\len\   ;iidieis  prorr 


s 


VZi 


THK    MT'SCI.KS    OF   THE    FORF,AR^r. 


K): 


muscle  which  is  in  immediate  relation  in  the  forearm  with  the  sui'orticial  layer  of  the  tlexor 

surface  (see  jjai^e  iQi)- 

T  arises  fro:n  the  es.ernal  intermuscular  sei)tum  of  the  uj.per  arm,  where  it  is  in  mimediate 
relation  with  the  outer  portion  of  the  brachialis  on  the  one  >ide  an<l  with  the  ouier  head  (or  inner 
head,  see  page  i.,o)  of  the  triceps  on  the  other  (Fi-s.  J70  and  -'71).  The  ori-in  ends  some 
distance  above  the  external  epicondyle.  In  the  forearm  the  brachiora.liaiis  becomes  somewhat 
narrower,  covers  the  supinator  and  the  insertion  of  the  pronator  teres  (Fi-s.  274  and  275),  and, 
in  the  middle  of  the  forearm,  terminates  in  a  llat  tendon  which  nms  ovi  r  liie  insertion  of  the 
pronator  <|u;>.iratus  to  be  attached  to  the  uii!>er  end  of  the  styloi.l  proce-s  of  the  radiu.,. 
The  radial  nerve  passes  between  the  outer  portion  of  llu  brachialis  and  the  braci.ioradiali-. 

The  musilris  ^upi'lii'l  I'v  lli.'  ra.li.il  m-rvr.  ll  i>  prarlically  .,  Iloxor  ..f  th,-  fnr.arni,  an.l  tl.r  n.inir,  Mi|.inal..r 
lonnus,  foriiicrlv   '-  niic'     i  it,  iW<  net  iDrrrilly  state  its  fi'mti.>n. 

T'.ie  txtensor  carpi  radialis  longus  (riuli,i/is  i:\iiriius  loutiiis]  (Fi>;-.  270,  271,  and  278> 
is  a  long  llat  muM  le  resemblin.i,'  the  brachinradialis.  Ii  arisen  as  a  direct  t dntinuation  c  die 
origin  of  the  latter  muscle,  from  the  lowr  end  of  the  exlern.il  ml.  rmuscular  septum  of  llie  upin  r 
arm  and  from  the  e\trrnal  epicondyle  opposite  to  tlie  lowermost  (lorlion  of  the  inner  head  of  lite 
triceiis  (Fig>.  270  and  271)  (see  page  i<)0(,  and  terminates  above  llie  middle  of  tin-  fonarm  in 
a  somewhat  llatlened  tendon.  It  lie-,  immediately  adjaicni  m  the  brae  nioradial,-.  (iiiion  its 
ulnar  md  somewhat  jjosteriorly  1,  covers  ihe  vi.lar  and  iatirai  Mirfaccs  of  tht-  rathiis,  pa-ses 

heneai  dor>al  carjuil  ligaiuent,  ai;  1  insert-  into  the  dorsal  >urfaie  of  the  base  of  the  xtond 

metacar]al  i)oni-  (see  also  ]iage  20\\. 

The  extensor  carpi  radialis  brevis  (nnliiilis  rxirnins  hnils)  iFig-.  270.  271,  and  278! 
lies  immediately  bcMde  the  Immuu--.  It  ari^s  jus:  lulow  the  lall.r  must  Ir  from  the  exit  rnal 
epicnndvie,  the  aiitibrachial  laxia,  and  the  articular  tap  ule  of  tin-  .Ibnw  joii,,;  i(  cMwr-  .hr 
lateial  -iirlaie  of  tlie  nidiiis  and  lieiomes  tmiliinui-  sonu  v,  ;al  IuI.av  ilir  middle  of  llic  lonant'. 
The  tlatteneil  liiitlon  is  longer  th  n  that  of  thf  loiigil-,  wiih  whii  h  it  passes  beneath  tin-  dorsal 
carpal  ligament,  and  i-  inserted  into  tlu-  ba-c  of  llic  third  mdaiarp.d  buni'. 

Both  I'Xtensdir-  tarpi  '-adiali-  are  stio]'lir(l  b\  llu-  r.idial  tier\>  .  TdL'rd'.i  r  with  the  rxler-.>r 
cari>i  idnari>  thev  produtv  dorsd  llexion;  and  wilh  ihr  lit  \or  tarpi  radi.ili-  ihr>  cited  radial 
(lexion  (radial  abduction).  Their  temlon-  are  ii-(i"td  in  ihr  Inr.arm  l.\  ih.-  e\lin-or  polli.  1- 
bv(,\i..,  and  the  abdu'lor  pollit  i-  longu-.  and  tlu  ir  iiiserlion- are  iio-ed  by  llu-  I.  ii<lon  ol  llu- 
exu-iisor  pollii  is  lon.Ms. 


THE  MUSCLES  OF  THE  EXTENSOR  SURFACE. 

Willi  lii(    exifpli'in  of  llu- .si'pinalois,  lilt-  ixtinMii>  ,ir.    .-iuialtd   to  ihe   ulnar  >idc  ot    llu- 

radi.d   gKiup. 

Tlu-  supinator  suipiuaUn-  hi;-,-ist  1  Fi;:-.  275  lo  27-  and  2S0!  i-  a  llal  iiuim  K    wlii.  li  (i:r\(- 

1        ,  .1 _  ...  ,_ :...  .  ;  ll...  »..,i;,,^  ..,,,1  ;.  ;.,  i-..l.ii  L.m  «  ii!i  1:1  mhv  nf  llu-  niu-i  Ics  <il  the  liiri 

arm.      lis  origin  is  concealed  by  ihe  anion' Ms,  its  midtlle  portion  by  the  siipirii,  lal  e\t(-n--i>r-, 
anil  its  anterior  ivojari  portion  by  ihe  radial  group  and  the  pronator  teres.      The  insertion  ot  the 


196 


ATLAS    AND   TEXT-BOOK    "F   HUM,  X    ANATOMY. 


Fk;.  279. — Tlic  suitcrlkial  layer  of  muscles  of  the  ..-xtensor  surface  of  the  forearm. 
Fig.  2S0. — The  (leej)  laver  of  muscles  of  the  e.\tensor  surface  of  the  forearm. 

The  superficial  lavir  i)f  thi-  <xu-nsi')rs  has  Ix-cn  rcmovid,  thr  cavities  of  the  <lor?al  cariial  ligamoni  have  been  opened 
and  the  tendons  of  t'.e  superficial  muscles  removed. 


muscle  is  in  immediate  relation  with  the  insertion  of  the  tendon  of  the  biceps  and  with  the  bicipito- 
radial  bursa. 

It  arises  from  the  e.xternal  epicondylc  of  the  humerus,  from  the  radial  lateral  and  annular 
ligaments  of  the  ellxnv- joint,  and  from  the  supinator  rid{rp  of  the  ulna.  It  is  tendinous  at  its 
orifiin  and  usually  exhibits  a  su])crficial  aponeurosis  in  the  middle  cf  its  course.  Some  of  the 
fibers  run  almost  horizontally  and  some  of  them  obliquely  forward  a  .d  downward,  paFsing  to 
the  upper,  outer,  and  lower  portion  of  the  tuberosity  of  the  radius  and  to  the  voiar  surface  and 
border,  the  outer  surface,  the  dorsal  surface  and  Iwrder  of  the  same  bone.  The  fibers  passing 
to  the  volar  tx)rder  terminate  immediately  alxive  the  insertion  of  the  pronator  ( radii )  teres. 

The  muscle  usually  consists  of  a  suiierficial  and  of  a  deep  jiortion  which  are  not  sharjily 
differentiated,  and  between  the  two  portions  the  deep  (])Osterior  interosseous)  branch  of  the  radial 
nerve  passes. 

The  supinator  is  supplied  hv  the  radial  nerve.     .\s  its  name  indicates,  it  supinates  the  forearm. 
THE  SUPERFICIAL  LAYER  OF  THE  EXTENSORS. 

This  layer  consists  of  three  muscles,  adherent  to  each,  other  at  their  origins,  m  lich  are  partly 
in  (ommon  with  the  extensor  carjii  radiali^  brevis  from  the  external  epicondylc  of  the  humerus 
and  the  antibrachial  fascia,  and  tliey  terminate  in  tendons  whii  h  are  distin-  'ly  directed  toward 
the  ulnar  side  and  pass  beneath  the  dor.s;il  carjial  ligament  to  llu  back  ot  hand.      They  are 

situated  in  the  dorsal  region  of  the  forearm,  chietly  upon  the  dorsal  surface  of  the  ulna  (and  upon 
the  supinator  al)ovei,  and  are  in  relation  externally  with  the  extensor  car])i  radialis  brevis,  inter- 
nallv  wiih  the  anconeus  and  l)elow  with  ihi   tlexor  car])i  ulnaris. 

The  extensor  digitonim  communis  (Figs.  27S,  sjc),  and  2S())  is  a  l)road,  flat,  strong 
muscle  which  arises  from  the  external  epiiondyle  of  the  humerus  and  the  antibrachial 
fascia;  it  is  intimately  adherent  to  the  extensor  digili  V  and  partly  to  the  exten.sor  carpi  radialis 
brevis.  Somewhat  beiow  the  middle  of  the  foicarni  it  divides  into  three  (or  four)  bellies 
(Fig.  27())  which  terminate  in  round  tendor.s  the  ulnar  one  gives  olT  tendons  for  lK)th  the  ring 
and  little  fingers  when  "uly  three  belliis  arc  iiresent.  The  tendons  pass  beneath  the  dorsal 
caq)al  ligament  !<>  the  back  of  the  hand  (Fig.  2«()l,  where  those  for  the  ulnar  tuigers  are 
connected  by  slender  transverse  or  olilitpie  tendinous  fascitiili.  the  iniirliira  loidiiiiim.  In  the 
fingers,  these  tendons  form  the  main  portion  i>f  the  dorsal  a])oneurosis. 

The  extensor  digiti  V  proprius  iFigs.  270  and  28())  is  a  thin  slender  musde  which  is  so 
closely  connected  with  the  extensor  digitorum  communis  that  it  seems  to  Ix'  a  part  of  it.  Its 
slender  tendon  passes  through  a  se!)arate  compartment  in  the  dorsal  carjtal  ligament  to  the 
dorsal  aponeurosis  of  the  little  finger  (Fig.  281)  and  is  sometimes  double,  taking  the  place  oi  the 
tendon  of  the  extensor  communis  to  the  little  finger,  whith  may  be  poorly  developed  or  even 
absent  1  Fig.  28(>i. 


Ute 


Brachialis- 


W 


Radial  lateral  ligament- 


Annular  tigan-  it 


I  m 


Pronator  teres  x  /  K 


Flexor  carpi  ulnaris 


Abductor  iiollicis  long.— 
Extensor  potlicis  brtvis 

Temions  of  exten- . 
sores  carpi  radial- 
Extensor  pollim'-^j^rr^r,!  carpal  iigcmr. 
long. 


Fig.  27Q 


>  Extensor  dig.  V 
proprius 


Extensor  indicts  pr 


Win 


^y  Dorsal  carpal 
ligament  x 


,'     Tendon  ofextensoris  carpi  radial,  brtvis 
Tendon  ofextensoris  carpi  radial-  longi 


Fig.  280. 


npm 


vm-m 


TUl.    MUSt:i.I.S   OF    THK   FORKARM. 


197 


Roth  muscles  an-  supplied  from  tin-  r.,lial  mrvr.     Tlu-y  .NUnd  llu-  luur  ulnar  linp-r.    .sp,-,  iaily  ll'air  ,,ruxi,ua- 
phalanges 

The  extensor  carpi  ulnaris  (iihuiris  exlmius)  (Fi.us.  270  and  28())  arisis  t()<;ctlur  with  the 
two  other  muscles  of  this  Kroup  from  the  external  epieondyle  of  the  hunieni>,  and  also  from  the 
articular  ca])sule  of  the  elbow-joinl  and  (luite  extensively  from  the  antil.rarhial  fascia,  vvitli  xvhu  ii 
the  muscle  is  adherent  for  almost  half  of  its  emire  lenRth.  It  is  in  relation  above  wuh  the  anco 
neus  and  lower  down  '  separated  from  the  llexor  caq.i  ulnaris  l,y  the  dorsal  bortler  of  the  ulna. 
It  pas.ses  over  the  dorsal  .surface  of  the  ulna,  becomes  tendinous  in  the  lower  third  uf  the  forearm, 
runs  beneath  the  dor>al  caq.al  li-ament,  and  inserts  into  the  base  of  the  fifth  nuta.  ar,,al  l)one. 

Tlu-  exu-usor  ,  arpi  ulnaris  i.  M,ppli,.l  from  th,-  radial  n,  rv,  .  Win  n  a.li.,..,'  vilh  th-  ,vu  n^orr,  ,  arpi  ra.liaU-  it 
procUuc-  dorsal  llexion,  anil  loi-etluT  witl,  the  ll.  xor  ,arpi  ulnari-  it  ,  If.  .  K  ulnar  ll.xion  (ulnar  ahdmllonl. 

THE  DEEP  OBLIQUE  GROUP  OF  EXTENSORS 

This  layer  is  differentiated  from  the  deep  strai-ht  i^roup  by  the  fact  that  only  the  ori-in> 
of  the  muscles  comprising  it  are  conceale.l  by  the  superfuial  extensors.  The  muscle^  b.rome 
superficial  below  and  cross  the  tendons  of  botli  extensores  can)i  radiales  in  the  lower  third  o\  tlie 
forearm,     l-ike  the  muscks  of  the  deei)  Hexor  tirou]),  they  pass  over  only  the  wrist  joint. 

The  abductor  pollicis  longus  (ixlntsi>r  o.ssis  miUuarpi  polluis)  (Im^s.  nyt),  ->So.  and  2K()i, 
the  outermost  of  the  group,  is  a  tlal  strong  muscle,  the  origin  of  which  is  comiiletely  concealed  liy 
the  .superficial  group  of  extensors.  It  has  a  long  pointe.l  origin  from  the  dorsal  surface  ol  the 
ulna  and  also  arises  from  the  interosseous  membrane  and  from  the  tiorsal  surtace  ot  the  radiu^ 
below  the  insertion  of  the  supinator.  In  the  lower  third  of  the  forearm  il  t  rosses,  together  with 
the  extensor  pollicis  brevis,  the  tendons  of  the  extensores  carpi  nidiales  at  an  acute  angle  a  ,d 
terminates  in  a  tendon  (or  two  tendons)  which  passes  beneath  I'.e  dorsal  carpal  ligament  lo  be 
inserted  chietlv  into  the  l)ase  .d'  the  metacarpal  bone  of  the  thumi).  Tendinous  fibers  usually 
.idiate  also  to  the  greater  multangular  bone  and  to  the  abductor  pollicis  brevis  (see  i)age  iqt)). 

•n,..  „u,s,  k  i.  .u,.pli>d  iron,  tl-  radial  .rerv.  .      Il  a!,du,l.  ll„-  thun.l.  and  al-  a-.i,.,  in  th-  ,  stcuMon  ..f  tlu.  .I,«il 

The  extensor  pollicis  brevis  (Figs.  270,  280,  and  28QI  is  situated  more  t..  ihe  ulnar  side 
and  is  bv  far  the  weakest  muscle  of  the  group.  It  is  a  slender  muscle,  situated  immediately 
alongside!'  of  the  abductor,  and  arises  from  the  interosseous  membrane  and  from  the  dorsal  surface 
.,;  the  radius.  It  crosses  the  ten.lons  of  the  extensores  carjii  radiales  and  its  slender  tendon 
passes  through  the  same  compartment  as  the  abductor  (Fig.  28()l  and  is  in.serted  into  the  dorsal 
aponeurosis  of  the  first  phalanx  of  the  thuml). 

It  i,  ,u!)plicd  Ir.un  i!«  radial  mrvv.      It  .-M.nd.  and  ahdu.t.  th.'  tir.t  phalanx  ..f  tlu  ihinnh. 
THE  DEEP  STRAIGHT  GROUP  OF  F.XTENSORS. 

The  muscles  of  this  group  lie  immediately  to  the  ulnar  side  of  the  preceding,  but  they  are 
deeply  placed  in  the  forearm  and  are  completely  concealed  l)v  the  sui)erlitial  extensors. 

Th.  extensor  pollicis  longus  (Figs.  27c),  280,  and  28t,)  is  stronger  than  the  brevi-.  It 
aris.  ■  from  the  dorsal  surface  of  ,he  ulna  and  from  the  interosseous  membrane  and  lorm-  a 


198  ATLAS    AXn   TEXT-BOOK   OF    HVMAN    ANATOMY. 

Fir..  2S1.— Tcn(ions  and  musrlcs  (intcrossei  dorsales)  of  the  (K)rsum  f)f  the  hand. 
The  iliir^al  <ar|);il  ligament  H  rctainrc!,  the  rest  of  the  dorsal  fuseia  tx-in};  n-movnl. 

Vu,.  282. — The  ))almar  a|)o?ieurosis  and  the  palmaris  brevis. 
The  thenar  am!  hypothenar  nniseles  are  shi>wn  eovored  !«•  the  fasiia. 

long,  slcndiT,  muscular  belly  which  ]iasscs  (lo\vn\\ar(l  to  the  wrisl-jtiint  beside  the  extensor 
(ligiiorum  communis.  Just  before  reachinjj;  the  wrist  it  terminates  in  a  tendon  which  passes 
throuj^h  a  S]>ecial  com]>artnHnt  in  the  dorsal  carpal  ligament  (Fig.  2Si)i,  crosses*  the  In  Ions 
of  the  e.xlensores  carpi  radiales  imim-diately  before  their  insertion,  and  is  attached  to  the  ungual 
jihalanx  of  the  thumb,  being  partly  adherent  to  the  tendon  of  the  extensor  ])ollicis  brevis. 

'Ihi^nui^i  K'  IsaKosupi'lie.]  from  the  radial  nervi .  I,  extend- the  ungual  ph.il  -sx  of  the  lluuiih  and  assists  the  action 
of  ihe  alidui  lor. 

The  extensor  indicis  proprius  (the  iiulicalor)  (Figs.  2-q,  280,  and  281)1  is  a  long  blender 
muscle  situated  to  the  ulnar  side  of  the  extensor  poliicis  longus.  It  arises  chiclly  from  the  dorsal 
surface  of  the  ulna,  receiving  adfliiional  libers  from  the  interosseous  nietnhrane,  is  com])letely 
concealed  l)v  the  extensor  digitorum  commu'^'s,  and  passes  ihrough  the  dorsal  cari)al  liga- 
ment in  the  same  compartment  wit'  the  latter  n.uscle  i  Fig.  j8i)i.  Just  above  the  wrist-joint 
it  terminates  in  a  tendon  which  runs  on  the  dorsuf''  of  the  hand  alongside  of  the  tendon  ol  the 
communis  for  the  index-finger  and  forms  with  this  tindon  the  dorsal  a])oneurosis  of  that  finger. 

Il  is  ^up|llied  from  ihe  railial  nerve.      Il  aid~  in  ihe  e\len-.ion  of  liie  iiidex-fmger. 


THE  MUSCLES  OF  THE  HAND. 

Tile  tlienar  and  hyjiotlienar  eir.itKiices  o(xupy  r>-spectively  the  radial  and  ulnar  bor- 
ders of  the  hand,  l)ut  the  'lexor  tendons  and  lunihricales,  running  in  tile  middle  of  the  ]ialm.  are 
cowivd  hv  a  strong  aponeurosis  which  is  u>ually  a  direct  radiation  of  the  tendon  of  the  palmaris 
longus  i-ee  page  !(Ki  and  is  isnown  as  the  palmar  aponciirvxh  1  Fig.  284;  (the  palmar  fascial. 
This  aponeurosis  is  alw:iys  ronneded  with  the  lran-\erse  (arjial  liganu'Ut  and  g.-'  (les 

awav  u])on  eitlur  side  into  the  fascia  of  the  thenar  and  hyiiotlicnar  eminenco.      i.  iw  at 

tile  tran-verse  cari)al  ligament  and  becomes  broader  a-  il  pa>M's  downward  lowani  .  ..•  lingers, 
anil  il>  longitudinal  faM-iculi.  which  gradually  disappear  in  i!k'  integument  over  the  Ijases  of  the 
proximal  |ilialangcs  of  the  -cmnd  to  tlie  fifth  lingers,  arc  united  in  the  distal  i)ortion  (-f  the  ])altTi 
i)v  transverse  fasciculi,  wliiih  i  lose  in  the  interspaces  lying  helwcen  the  longitudinal  fasciculi 
])assing  to  the  individual  finger-.  Tlu-e  spaces  gi\e  pa>>agc  to  the  vessels  and  nerves  for  the 
marL'ins  of  the  finders,  and  henealh  them  are  >iiuated  the  lumliricales. 

The  ulnar  margin  of  the  denser  central  ]'onion  of  tiie  palmar  aponeuro-i-  and  the  transvirse 
cari)al  ligament  give  origin  to  a  muhde  which  passes  over  the  muscles  of  ihi'  hyiiothenar  emi- 
nence ,ind  llu-  ulnar  ve->el-  to  the  integument  at  the  ulnar  border  of  llie  hand.  This  muscle  is 
situated  cntirelv  within  the  suiiorhcial  lascia  ol  the  palm,  vaiies  in  it-  development  in  dilTerent 
individuals,  and  is  termed  the  palmaris  brevis  1 1-'ig.  282). 

*  This  iro^-ing  oei  in-  « it  bin  llu  dor-.il  .  arpal  Imainenl,  -o  il.at  the  tmdon -heaths  al>o  ■  ro>s  eai  h  other  (-ei'  the 
deseri|ition  oi  the  tendon  -hiaih~of  tin-  hand,  )Mg<-  joj!. 


-! 


'  ^.-z  .- 


■IH— P-~~»" 


m 


ilUi 


^ 


199 

"•""""^^"'"T-^....-^ "-' 

u  „f  'oil"  t.irv,-  ana  i^ 

,...uppUe..y.he.upeH..a>vo.aH.aneH.. 

of  the  hand. 

,„H  »SC.^    or  THE  THENAR  ^^  ,  „.  „  .,  o, 

phalanx  of  thclhumb.     U  >^  " 
longus  (sec  vaj^c  iQ?)- 

„,1  -ibdM.  t^  lb.-  tln'ml'- 

.  ^,^^     n.o<kra,.ly  >u-on,  nmsdc 

«^    '8_i  ana-^<)0)i>;i'^'il'i^'^^      ,'  from  tho  lulHTosiiy 

The  opponenspolUcis.^..- -^v -J^;  ,^  ^„,,,,„  ,..vi.     U  --^.^^    ,\.^,,,,„  .,ul 

-r:::r;:ri;-7?  :rr::-^^^^^^    ^ - 

tens  bv  oblique,  partly  U.n<hn..u.i>bcr 
carpal  bone  oHbe  thumb. 


;:;-T•-':S■':;:n;;^^:-'^^-^;?'"' ■■•■''■ ™ 

...         ,,    ,s,  ami  2,r^^  is  situau-a  ui  'l^^.'':'"'  ,  ,„  ,he  lum- 

The  adductor  pou-s  ^^;^;--;;;^;, :,,,.,. ..  u.  «-"-'';::::-;:;■  z;:!,  .hieh  have 


ma^J^^ 


200 


ATLAS    AND    TEXT-ROOK    OF    HUMAN'    .V^ATO^^V■. 


Fir..  28-,.— Tlic  palmar  mu>clcs  after  removal  of  the  palmar  ai>oneurosir;. 
The  tcnilon-li.alli  .if  thr  nii.l.l!.-  lMij;,r  h;i.-.  iRcn  split  l,■n^•lll^vl^<■. 

Fic.    ^8a   -The  deep  laver  of  the  jjalmar  musilcs.  .   ,        ,  it,.! 

have  bfcn  iiartly  removed  ami  |>arlly  drawn  aside. 


the  bott<.m  <,f  the  carpal  canal  from  the  i^almar  surfaces  of  llie  lesser  nn,hanf,'ular  .trapezouli 
and  capitate  (os  niasnum)  Ixmes,  hut  the  greater  numlnr  ari^e  from  liu-  ,,al>nar  surface  ol  the 
sh.ft  of  the  I'.ird  tnetacaqial  bone,  and  pass  almost  hori/.ontally  toward  the  narrow  tendon  ot 
insertion  which  i>  attached  to  the  basal  phalanx  of  the  thumb  by  means  ol  the  ulnar  .se.samoi<l 
Iwne. 

The  muscle  i,  supplied  i.v  ,he  ,.ln,>r  rurve^     It  adduets  the  .huntl.,  i.  r.,  approvmale.  the  thumb  and  imlev-l-m;,.-,. 

THE  MUSCLES  OF  THE  HYPOTHENAR  EMINENCE. 

The  abductor  digiti  quinti  ( Fi'Js.  285  and  200)  i-^  the  .tron-est  and  innermo-t  muscle  of  the 
unnip.  Il  ari-e.  from  the  j, inform  bone,  sometimes  also  from  the  transverse  carpal  li-ameni, 
and  is  inserte.l  into  the  idnar  l)onkr  of  the  dorsal  aponeiiroM-  of  the  little  fin.ger. 

U  i,  -upplied  1.  the  uii.ar  „erve,  ;,„d  abdu. .-  the  little  l„e;er,  /.  ...  separate,  the  liitl,.  in.n,  the  rin^;  nns.T. 

The  flexor  digiti  quinti  brevis  ( Mj^s.  j8^  antl  j86i  arises  from  ilu-  transverse  (arpal  li-a- 
menl  anti  fn-m  the  hamulus  of  the  hamate  (unciform  1  iHtne.  it  i^  a  small  slen.ler  muscle  situated 
t.tthcra.lial  M.le  of  ihe  alHlticIor  and  mav  be  entirely  absent,  or  ftiM.I  «ilh  ihe  opponent.  In 
short  te.ul.mof  insertion  isaltaehe-l  besi.le  that  of  the  alHl.i.  fr  inf.  the  ba.s.l  phalanx  of  the  little 
lin.i^er. 

Il  i,  -uiM'lied  bv  the  ulnar  nerxe       It  l1e\e-  th.-  fir>i  phalanx  ..f  ihr  llttl,-  Ihiixer. 

The  opponens  digiti  quinti  (Fi-s.  .;8;v  28.,,  am!  j.»oi  ari-es  lo^ndher  with  the  precedin- 
muscle  aii.l  runs  to  the  ulnar  border  .d  the  nieta.  arpal  U-iie  <d'  the  little  linger. 

It  also  is  .supplied  l.s  the  ulnar  nerxe  and  ..p|.~  ,  the  httl.   line,  i 

THE  INTEROSSEI  AND  THE  I.UMBRICALES. 

The  interossei  .<.m],leleK  Till  Uie  interspaces  between  the  metacaqtal  Ivmes.     Those  mus 
(les  situateti  nearer  lo  the  .lorsd  surfac.    are  known  .is  ihe  nilmissri  ,/<.rv<;/cv,  those  nearer  the 
])alm,ir  surfaie  as  the  /H/rrnxM'/  ri'/.j/.  >. 

Ihe  ftuir  interossei  dorsales  I  Figs.  j8i.  jS;.  anil  jS.)i  are  l.uaied  in  the  dorsal  jMirtions 
(,f  ih.  four  interovM'oii-  sp.i.  es,  the  largist  being  tile  interossevis  .iorsali:-  primti-,  which  is  situated 
Ixtween  the  metacarpal  Ix.nes  of  tht  thumb  antl  index  finger.  They  arise  by  two  heads  from 
the  oppo-ile  surfaces  of  the  conliguou-  inela.  arpal  lH>nes  and  art  the  only  muscles  which  are  partly 
vi-JMe  h:rva      !■■.•  f.i-cia  ufjn  tlf   l>ai  k  of  th.'  hand.     Near  the  heails  of  the  metacarpal  Iwnes 


1 

1 

1  ^ 

I    ^ 

--•§ 

i  1 

l2     * 

^■5 

1  s- 

^    i: 

^^2 

>J 

11 


i 

g 


•a    5r      ^ 


5  ^     -tS 


i 


;* 


Mi 


f:-ff 


THE    MTISn.KS    OF    THE    HAND. 


20 1 


they  terminate  in  short  tendons  which  ra.liale  into  the  dorsal  aponeuroses  of  the  l)asal  j-halan^-es 
(see  pa<?e  20;)  [Vvj,.  jSh),  the  middle  linger  receiving;  the  tendons  of  llu-  second  and  tbird 
jscles?   while    the    lendon    of   the    first    passes   to   the    radial   side   of   the    indeN-tinL'rr,    and 


niusci 


that  of  the  laM  I0  the  ulnar  >ide  of  the  rini;-fin,L'i'r. 

The  interossei  volares  (,Fi-s.  .'8i  ami  jS-ji  are  three  in  number  and  arc  deej.ly  [.laced  ni 


yii//T./.(irii.?  ij/if «,.'.'/(  /.' 


/i(i*'T,i*.s(  H^  (Jor^  liJS  I 


tal'im 


Ti'iiii'xfs  '<;  lumliriialfS 


ln!rro\';nis  i/.<ri,;,';\  /// 
liitirnssfus  d'irsilis  IV 


I  fiiiii'ii',  ■•■  jii/cr.n«-i  ;  lAjr. 


Km.   JS5  -ni.ianm  iif  llu-  ,l(ir^.il  ,iixin.  up.-i  ■  ..f  ih.   fmRi-r-  in.l  ..I  lln  iriUn.,,,  i  ilor-^jlcs. 


the  palm,  the  tvo  ulnar  muscles  (th.  .econ.i  and  third)  i).in^:  sit.iate.l  In-id.  ih,  ahdu-ior  pnllin. 
and  Ih.'  first  or  ladial  one  beneath  th.'  latt.  r  miiM  le.  They  ari>e  by  a  sj„.u.  l„,,d,  the  lir>i  one 
comin-,'  from  the  ulnar  l«>rd.r  of  the  metacarpal  l^-ne  of  the  index  fin  ire  r  and  the  .  <  <.nd  and  ihinl 
fnmi  the  radial  sides  of  the  fourth  and  lifth  metacarT)al  Ixmes.  Kach  mas(  h  i>  iiiM  rted  into  thr 
extensor  lendon  of  the  fingiT  from  the  metacarpal  Ijone  of  whi.  h  it  taU,-  it^  origin.  Ih. 
ir.dex  fincer  (onsenucntiv  receives  the  tendon  of  an  interosseus  dorsalb  uj-on  il.  radial  sidi-  and 


k 


202 


ATLAS    AND    TK.XT-BOOK    OF    HI ■^^A^•    ANATOMY. 


Trttilim  of 
txtnisi>r  tliy/ifonim  ciiniiu. 


Tnidnii  oj 
inlcrnssciis  Tciidmi  ni  Inmliriiiilis 


Tcnil.nl  ,•■  ;h-x,:r  .li.JU'rum  fillil,"!  oj  ;hxi:r  Jl^iturum  silblimis 

pro/:iiliitis 
Ik.     vM,.-I)iai;r.Lm  -li.."iiim'i..-nl.ilinii.>f  ihc  uml..iu  ..f  ihr  iiil.r.i.-.,  i  ami  lunil.ri,  :il<;^  to  tlir  <ior.-al  ai»ii:.  ur,..-is  .,f 
the  liiii;'  r^  and  tli.  arranffnii  nt  .'f  ihr  lon(;  lli  xor  t.nil.;n  ..1  ilu'  liiiKi  r-. 


Tnnlmis  «l 
;h\vr  ,//.,■/- 
/  mm  pro- 
fundus 
Lnnihri'  lUis 

IV 

I.u'v'r:.  ,/,, 

III 


Trml.on  oj  ■h\or 

dicjforunt  fro;un- 

dny    '< 


t\>:.   .'H;  — I)Mi;ram  ..f  ttii-  inl.  nw^i  i  vo!.iris. 


l-'lii.  jS-v.     l)i.ii;tam  "I  tli'   kmilirii  .ilcs. 


i^a^'  '^^^m^^im^^mimmi 


Till-;    AIVSCMS    OK    TTIK   HANP. 


20; 


the  tendon  of  an  intcrosscus  volaris  uj.on  it>  ulnar  >\i\v;  the  middle  Im^'er  has  iw..  ml  iovmi 
dorsales;  the  ring-lmj^'er  has  a  volar  tendon  uiK.n  its  radial,  and  a  dorsal  tend.ni  upon  its  ulnar 
side;  and  the  link'  linger  received  a  sin!,de  tendon,  that  of  the  third  inlerosseus  volaris,  upon  its 
radial  side.  The  interossei  dorsali  s  re  posterior  an<l  the  inlero-s.  i  volares  anterior  to  the  trans 
verse  caiiitular  li-aments  (see  page  i27>,  xvhieh  conswiuently  sej^aiaie  the  tuo  .^nnips  of  interossei 
in  the  region  of  their  insertions. 

[  V,  .f.u-.l  al.uvr,  i,  i~  .  u>t..marv  .0  r,-,  n^;ni/.■  but  ihr.v  int.  f.^M^i  vnl;,rr.,  A  l..nnli  i-,  h..^^^^.■r  prrM„t  in  tl.r  i,.>->ii 
of  ,,n  ,-N.v,.,linKlv  hmWr  nn,- 1.-  wlii.i,  .i,-i>.'>  frun,  th,  InM  ,n,..„,,i,ul  ..n.l  i~  in-,  rtr.l  n,...  .!..■  nln.n  -..!,■  .4  th.-  I..,..' 
„f  th.  l-.r.-t  ,,h.lanv  „f  In.  ihuniL  ;,IonK  witl,  th.-  ulnar  lua.l  ,,f  tlv  -Lx,,,-  hn^i.  ,,.,lli.  i-.  ui-h  ^^hi,  1,  nu,-,  I.  n  ,.  (,.■.,»,  nlly 
nion- .ir  li-^s  I'McnsiviIy  fused.- i:ri.]  .,  , 

Ml  ,,:  llu-  i>U,T,.->.-i  ar.-  wsiullv  sui.|.ii..l  l.v  ih.-  nln.,,-  u.■r^,.  Th.  v  .  ilb.T  al»|...  1  ..r  ...l.lu,  t  th.-  In.«.  .  -,  ,  h,  nn,,,!!.- 
nnmr  mnv  b.- P,..v,-<1  unvanl  eith.-r  tin-  in,l.A.hnt;,T  .,r  rint;  hnt;.  r  by  th.- ...  li.in  .,f  i;- int.  n,.-. .  .|..,-.,l.  th.- n.  n  n,i,  r- 
.,-s™.  .l..i^^.ais  ,,ulls  th.-  it,.l.-x-lin^;,r  l,m-.,ni  tit.-  thutttb;  th,-  la,t  .,n.-  .Iraw.  th,-  rinu  hntt.r  t.a.var.l  th.-  bill.  hn^;. ..  I  h.^ 
,n-,t  v.,iari.  ,mll.  th.-  i.i.l.-x  f.war.l  th.-  mi.l-li.-  hnt;,-r;  th.-  -,.-,...1.1  .Ir.tw-  tb.-  rinu  t....ar.l  th.  nn.l.ll.-  tin,-,  r;  ,,n,l  tlu  thii.l 
adducts  th-  httU-  t,.war.l  th,-  rint;fmn,r.     Th.-  int.-r.,.ssi-i  aK.,  ;-  -  IM  th,-  a,ti,.n  .-f  th.   bnnbii,  ai,~  .-  .    1  .  l,.«  1. 

The  fciur  himhriailis  ,  Fi-^.  2.^,^  2,S(.,  2.S.S,  and  ->()0i  are  lon.t;,  narrow,  wtirni  like  niustles 
whieh  ariM-  .leep  in  the  palm  frt.m  the  f.mr  tendons  of  the  llexor  .li..iib-rum  profunilus.  Th,  two 
radial  lauseli-s  arisi-  hv  a  single  lu-atl  from  thi-  radial  borders  of  the  two  ra<lial  tendons,  v.iiile 
tlK-  uvn  uln.ir  must  ks' usually  arise-  by  two  ht-ads  from  the  adjarenl  border-  -if  th.-  ihrt-t-  uhuir 
tendons.  Near  the  ba-al  phalangi-s  of  th.-  lingers  they  i,-rminate  in  v.  ly  -1.  n<k  r  t.n.l.ms  whi.  h 
art-  in-erte.l,  from  the  radial  -i-le,  intn  the  .'.orsal  aiioneur.tses  „f  tit,  fuiLM-  in  ..>nini,.n  \sith  ihe 
interossei. 

Th.-  t-.v,,  ra.i;..l  lumliricali-s  ar,-  u.ualK-  ,,-i.|.li.-.l  by  th.  ni.-han  n.-iv.-,  th.-  tw<.  ulnar  by  tb.-  ubia:  ->,  rv.-.  'l  b,  y  ll.-x 
th,   ba>:ii  l.halani.',  <  ..f  th.-  litli!,-rs  all.l  ,  \t,n.l  tb,-  ■■  •  -.ml  -in.l  tibr.l  lilialani;,  -. 

THE  RELATIONS  OF  THE  EXTENSOR  TENDONS  AND  THEIR  SHEATHS  BENEATH  THE 

DORSAL  CARPAL  LIGAMENTS. 

A-  the  teiidnns  of  the-  .-Mens.n-  .d  du-  hand  an.l  ..f  the  lingers  jiass  M\er  ilu-  wiiM  joint  (Mgs 
280.  283,  a.i.l  2.S,,)  lluv  are  .  n,  I  ,-d  in  th,-  ■.vno^ial  sh.alhs  an.l  h,  Id  in  tit-  l'vo.im-  uj.on  lib- 
.l.trsal  slirfa..s  of  ih,-  ra,h,.  miuI  uln.i  liy  a  tlii,  k,  n.d  p.irtion  of  tlu-  air  'na,  hial  la-  ia.  ih,  ^lon„l 
,arf>al  >  posUno,  ,i,nn,!.ir,  liL'.im.-nl.  ■I'lu-  iii.livi.lual  -ymnial  -lualb  n  -ilual,,!  in  .lili.i.nl 
.omiiartnu  ,,1  iln  ligam,  la,  -in..-  thi-  -trmtuiv  i-aiia,  h..l  m  the  l.ingilu.hnal  lidg,-  upon  ih.- 
boiie-- .ind  ,-peiially  1"  ;  11— ,- .if  th,-  ladm-. 

■I'l,.-M-,,.inpartni,  111  ..ill  b.- .1,-^,  1  ibe.l  in  ill.- .ml.T  in  v.hi.  h  ih.  \  ,in-  ,  m  ot:  it, ml  in  i,i--ing 
iHim  th,-  radial  to  th.-  ulnar  .-i.le  <if  tin-  wri-i  1  Fi-s.  j.So  ami  J.S.,  Ih,  hnd..n-..l  ilu  ,  M,  ii-or 
inlli.isbr.-si-an.lab.lu.l.irpolli(i-lont'u>pa-lhrotu;ha,oinun  .ompartin,  nt  an,l  lo  a  ,.rlain 
.■M.tii  are  in\.Me.l  bv  a  ..Mnmoti  -\  ;io\  iaUh.ath.  T!u-s.-.on.l  ,  ..m^.a-ini.  iii  fiN.-  pa-;i-.'.- to  th, 
I.lid.in-  .if  th,  .-M.tiMir  ..tri  ,,|i,ili-  loni^u-  .tnd  brev  i-,  wlii,  b  u-ualb,  po-,  -  ■  -'  niu.il 
svno\ial  -1uaih-.  The  thi;-'l  .  .nniiarimenl  i-  -niu fiii  iallv  pla...l  in.l  i-  noi  lon;^ib,...ii.il  but 
..bli.|ue;  il  .fo-e-llu-  tendons  an.l  -ynovi.il  di,  ath- ,.f  ih,  iti.ir.  .l.-,p!v  -itualt.l  -,.on,l  .omoar! 
m.nt  at  an  a.  tite  angk  and  lont.iin-  tlu-  len.l.m  an.l  -ynoxial  -h.-alh  of  th.  ,  M.  n-or  imiIIi,  1- 
l.MiL'us.     NeM  follows  the  larg.-t  of  all  the  <  .mipar-  uent-;    il  .ontain-  111  ..  (.imnion  di.aih  ilu 


204 


ATLAS    AND   TF.XT-HOOK   OF    HUMAN    ANATOMY. 


four  tendons  of  the  extensor  digitoru  i  communis  and  that  of  the  extensor  indicis  proi)rius.  The 
fifth  eomiKirtment  contains  the  slencK."  tendon  of  the  extensor  digiti  X"  j-roprius  and  is  superficially 
situated.     The  Mxlh  and  last  compartment  gives  passage  to  the  tendon  of  the  extensor  carpi 

'  The  syno\'al  sheaths  are  considirahlv  longer  than  the  width  of  tlv  dorsal  carpal  ligament; 
those  of  the  extensores  communis,  indicis,  and  digiti  X'  may  extend  to  the  middle  of  the  meta- 
carpus. 

Tendons  nj  f.v/cin.ir  Jii^il.'nim 


Jtiihliir  r  tniilinuin    '-' 


/  .  ,1,1, III -\h  ■  nil  •',  rxtntsor    - ' 


l\ii,i.ni-sli,-i:l!  .■/  i-MeiiSiir' 
(  irpi  it'll  ir;^ 


I,  i:\,,r   (//i;.;  'mm    ,liui    :.\t(i:- 
.si'r  iihli,  i\ 


IiUir,is^,iis  il'irs.ilis  ! 


1  riuliiU'^h'-ilh  i>i  'Xtin'or  n.illici'i 

f,rr:'is 

'\   I  n:,l  -l\lie,llh  oj  ,lh.l li,  t.ir  piilliiis 
l<nii;lts 


I  ,'n,l„it-'hi-Uh  I'i  I  sunwr  fiuliu  /.!  /."^'Hi 


/     ft»ii„n-sh,:ilii  iij  rxinifiir  ,'irpi  r.iiliUit  Ami,'K( 
Trii,l,iil-.Jl,-irll  11/  ,\lnn,ir  ,,irlii  rhii, ill's  iirrris 


It.;.   .'S.)    -Tin   .i",miirnii'i\l  "(  t 


!„■  iiiulon^  ..f  tiK  I  vtin-.r  im.-.  1,~  aiv^  Tnilnn-.hr.alis  hfiualh  llir  tl.irs,il  ..irial 

Im.iminl  .iinl  in  tin  li.i'i'l  i -oniruh.it  -  -natic  ). 


THE  EXTENSOR  TENDONS  OF  THE  FINGERS. 

The  extensor  ten<lon>  or  dor.al  apuneuroM.  nl  the  fingers  i  ligs.  2,Si ,  'SO,  and  -'8(),  are  <  iiiefiy 
romoosed  ..f  the  ten.ion.  of  llu'  extensoirs  digilorum,  hut  al-c.  receive  fibers  from  the  tendons 
of  the  inlero>>ei  and  lumldnales. 


THi:    MLSCLKS   OF   THl".    1IAM>. 


.^O! 


The  tendon  of  the  extensor  or  those  of  .h>   t^vo  extensors*  which  pass  to  a  fmger,  beconu- 
flattened  in  the  region  of  the  metacarpo-phalanseal  joint  an<l  <livide  int..  a  stron-'  long.tud.na 
fasciculus,  which  continues  onward  in  the  same  direction  as  the  main  ten<lon,  iK.ssmg  to  the  head 
of" the  first  i.halanx  and  to  the  articular  capsule  between  the  first  and  secoml  i-halanges,  an.l  mto 
weaker  obli.iuc  fasciculi  whidi  unite  with  the  tendons  of  the  interossei.  ,  ,  •         . 

These  form  llat  expansions  .ver  the  basal  phalanges,  which  pass  to  the  lateral  margins  of 
the  extensor  tendon  (Fig.  286)  and  are  also  continued  to  the  middle  phalanges,  um.mg  with  the 
oblique  fasciculi  of  the  extensor  tendon  an.l  with  the  ten<lin..us  expansi..ns  ol  the  hm.br.cales 
proc  cling  from  the  ra.lial  si.les  of  the  finger.  These  lateral  fasciculi  of  the  d.^rsal  aponeun.Ms 
come  from  Ixnh  mar.ins  o'  the  finger,  unite  at  the  capsular  ligament  Ix.tween  the  secon.l  an.l 
third  phalanges,  and  are  inserted  together  int.,  the  base  .,f  the  latter  Ixme 

The  direct  continuation  of  the  extens..r  tendon  consef.uently  termmates  at  the  hia.l  ol  tlu 

^"""^Thetol  ap<.neur.>ses  are  "rmly  attache.l  t..  the  onvex  surfaces  of  th.-  phalanges  an.l  are 
intimately  connected  w^'H  the  articular  caj-sules  of  the  interphalangeal  j..mts. 

THE  TENDONS  AND  SYNOVIAL  SHEATHS  OF  THE  FLEXOR  TENDONS  IN  THE  PALM. 

]„st  as  the  exteuM.r  ten.l.ms  run  in  synovial  sheaths  upon  the  back  ..f  the  han.l,  s.,  wc-  find 
the  tendons  of  the  llexores  digit<,rum,  and  those  of  the  llexor  pollicis  L.ngus  an.l  tlexor  c.rp.  ra,h- 
alis  .urroun.le,l  bv  svn.nial  sheath^  an.l  passing  beneath  the  Irausv.rsr  carpal  U,, mm  ,n  the 
carpal  canal  (Figs.  .8,,  285,  an.l  2  p).  The  llexo;-  carpi  ulnari.  has  n..  synovial  sheath.  I  he 
outermost  synovial  shea.h  in  the  ca.pal  canal  ,Fig.  282)  is  that  of  the  tl.xor  carp,  ra.hahs,  whuh 
extends  t..  near  th.  inserti..n  ..f  the  ten.l.,n  an.l  is  alm.,st  enli.vly  .-onceale.l  by  tin.  ..r.gnis  ..1  the 
thenar  mus.les.     \,  xt  this  sheath  is  the  l.-ng  narr..w  ..ne  f.,r  the  tlex..r  p..ll..  >s  l.mgus,  wh.ch 

extemls  fn.rn  ,h.^  .p'-"  '"^"-Si"  "^  "^^'  ^^'"--■^^^'  ''''^'''^  "«=^"^^"^  '"  "^''  "'?'T  I/'^^''^'"". '"  ' ^' 
thumb.  Next  in  .n-der.  passing  towar.l  the  ulnar  si.le.  is  th..  large  sh.alh  wh,ch  eontams  the 
eight  len.ions  .,f  the  llexor  .ligit..rum  sublimit  an.l  pr.>fun.lus;  it  cmmences  al)..v..  the  transvet-se 
carpal  ligament  and  exten.ls  t..  about  -he  mi.l.Ue  ..f  the  palm.  Only  tiu^  svn.-vrd  slnath  t.>r  th.. 
tendons  .)f  the  little  finmr  i- .  ontinued  dire.tly  int..  the  tmger  itsell. 

The  fingers  p..ssess  >.parate  svn.nial  sheaths  (Fig.  2.p>,  ...mm.n.hig  at  th..  m.ta.  (,rp.>^ 
,,halan.-eal  pints  an.l  exten.ling  to  the  !....■>  of  tl^e  t.rminal  phalang...  wlti.h  a,v  .um.un.le.l 
bv  fibrni.  structures  kn.nvn  a.  the  vaginal  ligaments  ,  Fig.  28..  In  tlte  -li-tai  port,.,,,  ot  tlu- 
lingers  th..^..  sheaths  became  thinner  a.i.l  (ct  frcpiently  int..rn!pte.l,  an.l  a.  .■..-.hng  as  t..  wh..th..r 
thc'r  fas.iculi  cross  ea.h  .uher  ..r  are  arra,ige,l  circularly  i,t  this  Mtuati..n.  n-unal  a,„l  annular 

lii'am..nts  mav  be  .listingui<he.l. 

Ov.r  the  meta.arpal  b.nns  tli..  t..,i.l.ms  ..f  the  n..x"r  s,iblimi>  ,tM  i,nm,.,ha,.  ly  up.,n^thnM. 
„f  ,lH.  pn.fundus  within  the  teml..n-slu-alhs.  but  at  th.'  mi.M',  ..i  tl,e  firM  phaiang..  ihev  „.ule, 
forminl:  >lits  whi.h  give  passage  to  the  t.n.Ums  .f  the  pn.lOn.lus.  In  lhi>  Mfuaf.m  the  ,t..r 
,,n.l.u.s  bec.me  s..mewhat  broa.l.r,  exhibit  an  i.vlistin.t  nu-.lian  l^ngitu.itnai  n.snr...  a,,.  a,v 
eveniualiv  attached  t..  the   bases  of    the  ungual  phalang.'s.     Th.e  tu..  shps  ,.|   .a.  h  snbhnu. 


^Th.   i:^.:: 


uliins. 


k^j^: 


206 


ATLAS    AND    TEXT-BOOK   OK    HU.M/VN    .VNATOM\. 


'I  riuioii-slltdl}i  I'j  :l(.\  •!■  ■ 
Ahiwii'r  pi'lli'i-.  ''rr:i 


O/it""!!  "■'  ,''■■/''■'  "  I. •'"'■"' 


inij. 'II  ,•,  rxuiis.  urp:  r,itii-u    l^nir 

TflM'H-sh.f-ill'  !'■  :l''y'f  thiili'l-.  I,nii;lis 


l)ii;il'i!  \li,;illis  of 
tfitdoiis 


■  C'lnmu'ii  ttiid'"!- 
slir.llll  11;  jh-.wrcs 

dK,:. 


Opp'iifiis  di-^iii  V 


Trin'i-rrsr  r.irii'il  lii^itmnil 
■J'liid.iii  «:  iliwr  i.irfn  iilinris 


T  r.ia.m  ^::ri:i:   ■■;  ;:: 


;,  ._ JJ;iiM\   ,111,1   n't    :hx,:r 


,/,■„■.  firnjimdln 


ri,.,  j,,o.— Tlu'.irr.mn.ni.nt  ..(  th,    trn.l..ii-sli>  .uh-,  ■ 't   1 


h,   l.mi;  llr\.,r~.i  il"!   ih.- |K'\. .r  ...rpi   r.i.ii.ili- 1  M,in.« h.ii  .1 


THE   FASCIA   OF   THK   UPPER    EXTREMITY.  -°7 

tendon  pass  beneath  that  of  the  profundus  and  are  attaehed  to  th.  f  ^-^' --"--^;;;;;-;';^ 
1    .  .,,  flv.t  th,.  tendons  of  the  Ikxor  sul)limis  are  tonsc.iuently  pcrloratc-d  In  tho.c  .-1  the 

:;:::::"  irl  »,:'.■«*.>,.  ■>...  ...n,. m,  i„s„„.„  ;,„„  ,i, -n.. ...... .1..  ...... 

proiunuusiuL  ,    ,    '     ,       ry,       ,,  tindons   are   im   rcetlv  eonneelc-d  with    thr  IkimI 

t'l  rlll't^:^-    t^    <.f  ::w;."l.  ^"n.e  of  .h.h   ar.   thr.ad-li.e   .n.ifonn,. 

£:X '^  ,:^  uh;^Xse  in  the  noddle  phalanx,  are  triangular.  Tiu,  n-U  onl^-  c.,nneet 
:;!:  tenil^"ol  the  sublhnis  and  profundus  to  the  hasal  phalan..s,  but  al.o  those  of  the  pr..- 
fundus  to  the  middle  iihalanf^es. 

•l-HE  FASCLE  OF  THE  UPPER  EXTREMITY. 

The  muscular  masses  of  ,hc  upper  extremity  are  enveloped  by  a  o.mmon  faseia  (H^s.  ..,, 

and     '  )  -hieh  is  particularlv  w.ll  dcvdope.l  in  the  arm  and  .otvarm  at.l  whteh  ha>  ,....1 

d^.;cm  names  in  iilTetvnt  re.,ions.     M  the  shoulder  the.,v  are  r.o.nt.ed  at,  -:.y/  ..v,  a    «/^ 

,  an  n,jr„s,>ina,us.  and  a  .suksn,pular  /„,./„.•    in  the  arm.  the  l.raJn.l   ,,snu,  ,n   the 

o  "a  m'  t^  Jlil'rM  /—  and  in  the  hand,  the  .loru.l  l„sn,.  and  the  ^1.,,,.  ,, t>...,.ros,s 

X  v///„n.  /„./„  ,  Ki,.  .,  .  i>  a  thin  lau.  wl,iei>  elo.es  in  the  ax.Ua,.  eav.ty.  I.  ts  dt.-eti 
continls  below^with  the  mueh  s.rott.er  brachi.d  faseia,  i.  perf,.ntUj  by  a  ---;;• 
vessels,  ami  contains  .several  strong,  fasciculi  .sometimes  mu.cular)  v,hu  h  p.i>..  lion,  tli.  ia„. 

"  ^"^n;!;;/.-..  ;-'■/.'  -vers  the  supraspinatus  an.l  is  partly  u.dinoi.  in  '_'-;;-; ; 
The  n,n,s   hu,l„s  /„./„  ,Fi,.  .,8-  i>  a  very  elense.  ten.hnou.  .ase  ,a  wh  .  1,  .  o.eis  th     n.t 
spinll:.  the  teL  mi.or,  aiul  the  te-res  majo,.,  .ivin.  partial  ori,i„  ,o  the  Ur.  two  mu.le.^  and 
also  to  the  eleltoideus,  beneath  which  muse  le  it    '    uluaily  .l.>ap,.ear>. 

The.v,r^vn//>,</./r/.'.v'Mislhinandcenerstl>       ■.capulans  nu.>cle-  Hn„  f ,  ,  i.. 

The  l,nukial  jJia  ,  Vl^.  ....  an.l  :o.  >  is  .he  immeeliate  e,.„„nua,u,n  „,  th..  preevehn,  f,  ><  , 
.„.,  ^     .i.^.  thin  i.ve  the  insertion  of  the  deltotde-u.      1,  cot.i.^  .  lu-ly  o,  n---;     -'  '  ' 
and  u,l  it^  ante-rior  H.rfaev  ,1,..  ivlie  1  ,.f  .he.  hie.ps  may  be  .iiMmctly  ,ve.„n..e  d.  to  .  .  u  ,   Md 
"  V  e       uateel  the  .  v.r,,,,/  .uul   inl.n,.,l  lun pUal  ,ro.nrs.      In  tii,.  lo..r  par,  o.  the-  an,, 

lt:':i    nese.U  the  t.o  i..n,u..„!„r  .  ,„  .Inch  pa.  to  tlu-  bo,,  be-tweeii     le  ,.o  nm.  u   .. 
^,-oup>  of   thi.  region,  the  inlrnul  inUnnu.ul.r  .  punn   exten.hu,.   .L-nuaiel   „>   ,1,.    nncn.d 
cicon.lvK'  a,i.l  the  cxUnud  on.-  to  the  extei-nal  epie  .'ti.lyle. 
'       The  a,;uri.,r  surta.  .■  of  .he  fa.  ,a  e-xhibit.  orilieo  ,..r  th..  pa.a.e  .„  nUan....  n.  ...^  an.l 
veins,     do,-  further  <le,aii  sev  se.  ti.-ns  upon  ■■X..un.io.v"  .,nd  ■•.\nK,..l..^v.    , 

Th    .,.///.-.„/..,//.<-/.:  :Fi..  ...1.  -»^'  i..li,v.,ly  ..H„i„u.u,.w„h  dubnuiuailas.  a  ,n 
,vp.,     ..  the-  eii.nv  i.,ui,  ati.l,  .  ,.h  ,he  .-xe  ..,.,i,.n  ..f  one  :v,i..n,  ,.  c..ns,.le  ,-ably  .,.„„.  r  .a,,    h. 
fatia.     I,  i^  parti,  eliariv  .ietise  Ivlow  the  ,-e-,ion  of  ,h.-  eih.,..  .o,-m,n,  an  ap-me-u,...^  uh    h    - 
.Iheren,  ,o  ,he  supe-rlicial  laver..  of  the  llexor  an.l  e-x,e-n.or  mu.  1.  .  ,.-e  |.a„    ,.M  >.  an.hl,.-  /./-•, 
,        ,^       .  .  f  ,h,-  l-icep.  t.-ud.,n  .e-e  pa,.-  iSS^  i.  ,-e-aliv  form.-,l  bv  this  fa.ia.      1,  ,.  .  i.nne.  ,n 
L  cubital  f..>..  an.i  ove,-  the  l.a.  hiora.liali.  an.l  exten.-r  ea.pi  ra.liah.  i.,n,u.  unh  ulu.l,  „ 

'^Td:-';:::::-,po,-,,..noftl,ef..r.-a,-mthea,n,b,.a.h,a,fa.ia.. T  .lee-per  lav.,^  .h,.  li 

..nelos..    the    in.liu.lnal   mu.el.s   an.l   ten.l..,,..     ■lo.a.d   tlie   .,i.~.Ju,nt    the    ^olar    and    eiot.ai 


y^ 


if^^ 


M.^!m 


208 


ATLAS   AND   TEXT-BOOK   OF   HUiLVN    .VNATOMY. 

Fig   2gi  -The  fascia  of  the  left  arm  seen  from  the  volar  surface. 
Fig.  292.-The  fascia  of  the  left  arm  seen  fn.m  the  dorsal  surface. 


surftce.  arc  reinforced  bv  strong  circular  fibers,  forming  the  volar  carpal  ';^--""j!«;  J^J^j 
S!ch  is  situated  above  the  .rist-joinl  and  over  the  flexor  tendons  and  is  continuous  bv  its  distal 

..^hichpasse^J.^ 

t^  :r  Ih     ti^^      uti>-l  a4,artn.ents  for  the  extensor  tendon,  .see  page  .03). 
T^ie  W  / 1 :  ./  ,k.  Mnd  commences  at  the  distal  margin  of  the  dorsal  carpal  hgament 
.s  it^    V  ervthii,  .he  line  of  demarcation  is  much  more  noticeable  than  is  ^^e  one  bcu    -  ^ 
Hgament  and  the  an.ibrachial  fascia.    The  palmar  aponcnros.  (see  page  198)  .s  .ell  dc^eloped 
and  is  by  far  the  strongest  of  the  fascia;  of  the  upper  extremity. 

THE  MOST  IMPORTANT  BURS^  OF  THE  UPPER  EXTREMITY. 

,.  The  sulnuro,nial  hursa  is  situated  beneath  the  acromion  and  above  the  insertion  of  the 
tendon  of  the  supraspinatus. 

of  the  humerus. 

I.  s:  ;r:;'::r  ,:x:^ .: '.^^ir" n„„„  ,„  ,„.. ».,. .« .. 

greater  tubercular  ridge. 

-    The  hiirsa  oj  tlir  latissiimis  dors,  (see  pat  ■  '4^))- 

S'  The  sul.J„ro,.s  oUcranal  hursa  .Fig.  =    ->  between  the  olecranon  an.l  the  .k  n. 

I  The  'suluuiancous  rpianuiylar  burs.  unUrnal  an<l  ..■/,..„/.,  over  the  epuon-lMe.  of  the 

'"":rThe  nuralauUnous  and  subU;uUnous  olrn;nu,l  l.rs.  siuuUed  respectively  .i.hin  and 
upon  the  insertion  of  the  temlon  of  the  triceps  linconstant). 

II  The  bidpitoradial  bursa  (see  page  i8())  il'igs.  273  and  2,, I. 

'•  T      cuL  n„rrossrous  burs.,  between  the  uppcr  extremnas  o.  '•-  -<■-  ;        "^  ;^ 
:  The  bur.,  oj  tin-  r.lrusor  carpi  radialis  br.vis.  a.  .he  base  ol  the  thud  nKta.arpal  be  nu 
,;■  \tdL!sub,u„n,.ous   .,Lcarpopl,alan,ral  burs.,   inconstant   subctUaneous  burs, 
unon  the  dorsal  aspect  of  the  joints  ..f  the  same  name.              ^            ^     _  _^^    _^_  _^_^  ^.^^_   ^_^  ^^^^^ 
'      IV  The  dors.il  subculamous  dii^itai  bursa;  svilKUtaiuou^^  duis.l  uyr  :,  ,, 

proximal  interplialangeal  joints.  ,- ,1,,.  ,L.v„- ,-in)i  ulnaris  to  the 

^        ,6.  The  bursa  o]  the  jUxnr  unpi  ulnarh,  at  the  attachment  ..1  the  Ih  xo.  carp. 

idjiform  bone. 


/,V 


mL^itmk' 


V      -6*1    ■ 


Axillitrv  fast'iiT 


Crphatir 

I' fin . 


[I 


In  tf  inn  I 

intermuscular 

sff'tiim 


txtfrniil 

internutsailiV' 

sertnrrj 


[?■ 


/  lurriii^ 
tihmsii-^ 


/r/ 


\% 


Siifiiiil.i'if'':! 
,'iririt  ml 


V 


i4 


['oiiir  tiiivul  hiitinnnr 


Il."^,ll   ,<l>/»ll  i/<J.I/'l' r.t 


/if;.  21)1. 


Hi.'.  202. 


i^ii 


7*V;;^v!J?^'^;jurgn^fflr,y^-i.>-_,.^^j  ,.y^^'Wr 


THK    MT-Sn.KS    OF    THK    I.OWKR    KXT  U'.MITV. 


209 


>8.  The  inl.rmrlacarpophah,i>Kcal  bursa;  s.tuatc.l  at  tlu   m  uu.iqx  [ 
posterior  to  tlu-  lapitular  li^..;-'"ts. 

■    ,  .    vinmitv    ,,„  .-arli.-st  ililT.T,miatinnnl,M'n;it.UM<M  M-iurationuf 

[In  tlu-  ,k-v<-lo,.num  nl  tlK-  nnwU>  "I  llu-  u,,,.>-i-  ;        ^^^  ^^^   ^.^^^^^  ^^^^^^  ^,^^^j  ^^,,i,,,  |„,^  „|„„,  ,h,-  ,,..l.-n..r 

the  musrU-  sh.-,-t  xvhi. !,  U.-  vip-n  tlu-  |.oM>T,ur  or  ,M.n>,,    -       .  ,„„un„r  ,.r,  a-  tlu  v  „.,  |,r.  UrM.lv  l,n,u-.l. 

p„s,-u.u,l  mu.,l.s.  a.ul  a  s,  end  ,r.,t,i. -t  ,n.^a.,..l  ->- '' '  ^^  ^  ;^"^,„.^  „„.  ,^,,,,i.,„„,,„  „f  tlu-  cnls  ,.f  ,1,.   '.ra,  l.ial 
that  tlK-  fornu-r,  in  so  far  as  ,lu-y  ar.  su.M- u-.    '--^^^'^^ ,,.,,  „;,  ,„,^„  ,,..  ,,,,,H..,1  l,v  .Urivam.-  of  tlu-  .    .-i-r 
plexus,  mcixr  tlu-ir  ittnm-atum  through  t.-.  po^Uru.r  .oni, 
(;•.  c,  the  imiiT  anil  out.-rW'ords.  ,     ,-     ,        ,„„,nt~    ,- uivcii  al»A.,  mavllu  r,  fore  !..■ -.'I'liK  tiu  ■  tr.| 

The  elassilVation  of  the  limb  muscles  aeconhnK  ""!>'■  ''"''•  -  *^""  "'-  ''^  ^'" 
l,v  dlvi.li,tR  each  set  imo  a  ,.ost-axial  an,l  a  l'^'^-^';':''  »^;";';;  "l"^;,,,  ,,,1  „,,     ,,,„„,  ,„u.,  les  a.ul  the  -u,.er.u  i.,!   -nu-,  les 

■         1.  Thk  MfS.-i.KS  OF  Tin:  S11(H1.I>1,K   (to  whuh  ^ho.il.i  I..    a,l  I 

of  the  l.ac  k  with  the  eN.epti...!  of  the  tra|.e/.iu>l.  ^,^^^^,,,^.  ,„„,,„„,  ,/,/,„„/,-»,s.  w,,-..;- 

,„)   ,..,s.-axial  muscles:    ln:.U>r  so,^-,  rl'o'ohouUu.  «u.,.r.    /  .     ' '"' 

,/,>   I-re-axial  museles:    /.,-,/»r„/»  -»„;«r,  /-er/»^./^<  -  .w,M,„  <».,  an 

II.  Tin:  Misci.Ks  or  iiiK  vpi-kk  aum- 
(„^   I'ost-asial  nuisiles;    (r/.r/n.  .l>ini/H-H.v. 
(M   l're-axialniu>^le^:    I'i.rp^.  hr.uhuUis. 

III.  Tilt:  Mtsci.is  or  thi,  ioki  ahm.  _,^    .,      ■   ,.,„,„„;,  ,„,;.,-,,   ,,v/,-„s„. 
(.n    I^.s.-a^ial    nu.s.les:     / ■''"-"■"-'-"■";;.;;':/'„:';,     r.,,,,,.,,,,,-,    „/„/„....   ,-//-  /-.<-■  '— ^ 

,:„„,  „r..is,  r.,..s,:r  ^f-;^'";-;;;^  :";,-;::  ::;-:Z..  ,<U..r.  l.n,.s.  ,:..r  .,r,i  :,.,.,ri.  //--^  ■//./-""' 

ih\  Pre-'i\ial  nius(  es-    prinhii'>r  i'.'^.  ,.(.\''  ■      / 
suh/inus.  lt,'Xor  ,Ii,qilori,m  pr,<iumtu,,  jUxor  p.'hu  ,s  lo„,^ir  ,  a,      / 

IV.  The  Mi-sfLKS  or  riir.  u\ni>. 

,„)   r,st-axi.ll  museles:    wanting;  „..,„„-»,   /,-,///,;../;«-  hr,vi^    pollUh.    alnhu  :.>r 

(M  m-axial  muscles:    A""'"-.   -X;..!:  '     ;      i.t/,  /.-..^Wo,,^  ,.-/,/«./-  ^.//'-.  '"—  ^-^---  ' "' 

dorsales. — !'•"] 

THE  MUSCLES  OF  THE  LOWER  EXTREMITY. 

t::'^T:::rz^:r:z.f2:L  ,.„. , -»".-- ;- -  -^ 


M.l. 

tl; 


;,;;:;,:'::?;,::'„;:;;i:n:;::-":;:,»:-';; -4-;:;:;:;:;:", ;;:,;:;:,:: 


ini,nus.  an.!  tlu-  ,./.,'»r„/,.-  ,.v/,r;,».s.-  .v.A  ihos.  nl  iiu-  i)o 


niiundb 


,.1  il...  V,  iiw'i)).  mln-iiniisu< 


i:;,:  w  .IU-.V > , i„.n.i..i  .:..■  ---; < ";-  '7::':::'!;;"";:":;:;;: 


?m-?^. 


■'  I  Li; 


210 


ATI.AS    AND    TT.XT  BOOK    OF    IIIMAN    ANATOMY. 


f        .,r  .  .,rrin.'.<l  in  two  lavtTS,  the  supcrlKial  one  Ixinf.'  formed  by  the  iri- 

ri -u, ... ,i,.. ..<..-.>■  ..>■  '"t,;:! :,:.;:.;.  -.-«.' '■'■••■" "» 

ami  the  /«/.r,»..r/  are  al.o  situated  in  the  sole  of  the  foot. 

THE  MUSCLES  O^    THE  HIP. 
THE  INTERNAL  MUSCLES  OF  THE  HIP,  THE  ILIOPSOAS. 

.,n,l  ^noi  i>  (omix.-i'l  of  111"  A^.i.v  mnior  and  the 
The  iliopsoas  ,Fi,^.  .;.,  .0,  ^07.  ....  and  -^  '^  ^^,^  J  ,,^,^  ,,,,,.1  .^  „,,!, 

,//.,.  ».,wl,i.h  are  eompletely  se,arated  ,n  the  ui^per  poUmn  o, 

i,,.„,.n.  This  n.u.le  fre,,uen,lv  al.o  ineh.de.  ';;-;;;';-;.. ^,^  ^,  ^^,,,,,  ,  „„,,,  „,  .He 
•nu.  psoas  major  ,-  a  ion,.  >.ron,  mus.le,  tin  ^    •'^'''^f  ^,,^,, „„,.,.,. .f,!,,  twelfth 

posterior  aUlonnnai  .all.      1.  arises  from  the  upper  and  ''; ^       ^  p'^'  ^      ,^,^^.,.  ,„,  f,„„  „te 

i'->'-  -'■  -  ":■  ^-;-!'; ' -;,;.\'r ::,: :;;;;,; ,;; :  ;i:;: :;'.:  ^lii^^  ..n.u.  mmhar  ver,e^ 

''::;:   e':n:;:::-;^^^.'i;'•"n:.a;ed  ,.   „„    ...rs  proeeedm.  f,..n  the  vertebral  l.d.es. 

:,;;,;:;.:::  ^..-nin, ..  ...u.  p...  pa. ,., ;•-;;';;--:;;::;;::;;;,, ,.,  ,„, 

,„„.,,,K   ;„„1  |,.l,,u  uiih  the  inner  nKU-.n  ol  ihe  iluuu^       I  h.    inn.r  mar^ 

■'"■  'n"~  "';.'.m'.;,.!  iii.......  !■:.".- 1™™"'  '•""i"'->  !«»"■■" """"«"  "■" "',":"'"  '■"""■' 


THK    MUSCLICS   OF    THK    HIP. 


211 


j,,,t  th.a.  is  a  bur.,  whi.h  not  infrequently  n,n,nu.nica,.s.i,h  tlu-  ania,hu-  >avi,v,  ,1,.  i!iof.r. 

tiiual  hiirsii  (Fig.  2i)S).  ,         i    i,-     ;  .,n  , ^      li  1.,  ■!  llat 

V  psoas  minor  (Fig.  2,8)  is  present  in  sonu.vhat  more  than  hall  ol  all  .a>c  .  It  is  a  at 
thin'mtle.  Ivin,  upon  the  psoas  ntajor  an.l  aris,n,  Hon,  the  l.o.lv  o,  the  la.  ,  ..nuae  o  the 
tZ  Zl  a  vJne  Jand  from  the  in,ervertel>ral  .lise  between  the  two.  1  he  nu,.  le  soon  passes 
!;:;  !;  ;;!: Ldon  whieh  Ix^onK.  continuous  wuh  the  iliac  fas.  ia  eoverin.  the  thopsoas  ,sec  pa.e 
2;, I)  and  i>  inserted  with  thi^  fas.  ia  in  the  re-L.n  of 
the  iliopectineal  .■minence. 


'Ilu-  ilin|,s,,.,~  is  supiilira  fnmi  lb.  lu.'ilur  iiles...^.  H  A'""'^ 
,h,-  llnKh  an.l  al>.,  rnlal,  .  il  slinhuy  inuar.l.  -fh,-  [.s-as  .mn„r 
is  a  unsor  of  ihc  ili.u  fast  ia. 


■0 


THE  GLUTEAL  MUSCLES. 
The  glutaeus  maximus  di.u's.  2.),^  and  204^  '^ 
a  large  slron-  muscle,  particularly  thi.  k*  in  its  lower 
porti.m,  and  is  situate.l  in  the  ghit.al  re-i.m  im 
mediatelv  Ik  neath  the  skin.  It  is  covere.l  hy  a  thni 
layer  of  fascia  and  by  lite  layer  of  sub.  utan.-.ui^  lat 
which  is  very  well  <U'v.l.)p.e.l  in  this  MUialion. 

The  mus.l.-  arises  from  ihe  e\t.  rnal  -urfa.e  of 
the  ilium    (Fig.   2.),,)  bit  ween   the   1.0-terior  gluteal 
line  and  the  jiosterior  portion  of  the  ilia.  .  r.-t,  from 
the  i)osteri..r  surfa.c  .>f  ihe  sa.  rum  and  ...i.w  i.md 
fiom    the  posteri.>r  sa.r.nlia.   liganunt  in  thi>  Mlua 
tion),  and    from    die   >a.ro  lubenno  ligament.     Its 
hlnrs  iia^s   fmni  aUive   dowiiwanl   and   from  widiin 
outward.     The  faM  i.  uli  ar.'  vuuisually  thi.  k  an.l  -lis 
tin.tly  >eparate<l  fr.mi  .a.  h  ..th.r  by  penetrating  septa 
of  fas.ia  and  fat;  tlu'  l.)w.r  (imuri  fa-,  ieuli  are  the 
l.Mige-t.an.i  thi-  I'orlion  "\  th.'  muM  1,    is  tui..'  as 
thick  as  the  Ujipir  (.niter)  srgm.nt. 

The  superluial  fibers  .-f  the  nuis.l.,  espe.i.dly  .,.-,•  1  ,  1  ,,1, 
thoseof  tlu  upper  weaker  half,  pas-  over  the  greater  tro.  hanter  ,.,  th..  iho.d.ialhan.l  o,  h 
t-a  lltl  .see' page  2,..    -h..  .leeper  .d.ers,  particularly  .1...   l..g.  r   inf.,„.r  •.  a,.-   r,..! 

'""■  -n;.^n :;;;'  :!::;:;■;  margm  ,.  ,>.  gU.,a.us  nta.mus  is  m  re,a.ion  with  ,h..  p..s„.,ior  la.. 

.,f  ,H    Untd..,..  .rsal  fa'lia.  .her.^  this  s.ru.ture  gives  origin  ,.,  the  lat, tt.     the  -'-  n.  evt.       d 

,lni..n  is  in  ivladon  with  the  glutaus  me.lu.s  a„,l  the  glut.al  1...  ,,,    uhi,  h  .in.lops    1        ut  r 

,      t,       „  run -th..  tub..n.sity  .,f  the  i.  hium  an.l  the  ..rigius  o,  tlu  ,lev..r  group  o.  .      .  -^ 

;  MS,  tluse  latt.  r  making  tlu  ir  app.  arance  beneath  tl...  fas.  ia  below  ,h.   mneran.l  1 1 


i^\     '/:  .,....-70 

wtf 


^■.fAAJ' 


W.y    .,ll;:lll-  "1  111.    Ill"  '    l^l"'''  '  "1"'"  ''" 
,|,.l    iiin  .il  111.    ihan. 

Ih.    rl.lH.il  III..-. 11.    ..fti.  nt..lliV  111.  .I..U..I  lill'-- 


I  1.; 


♦   1  111    i;lill.lll-    m.lXiiil.l- 


i.m    "1  Ui.    liiii  Ml    III 


212 


ATIAS    AN1>   TEXT-BOOK    OF    HUMAN    ANATOMY. 


Tl>.  Rluui-us  maxi.nu.  has'lH-cn  .li^i<lo<^  an.l  rcflecU-.l.  

"^  •       .      Thr  insertion  conceals  the  tendinous  ori-in  of  the  vastus  lalcr- 

n,ar,in  of  the  «'"----;  ^  ![  X:  ;„,,,,,,  i.  separated  fro.  the  great  trochanter 
alis  from  the  trochanter  major  1  he  icnc.  i^  ,  ..^^...^  ,,.hi,h  there  is  usuallv  one  or  two  a.idi- 
,,..Utr.ehurs.t,the/.>c/...cn./,»«.  a.,,^    ,.K  xncaU..^  ^^^^^^  ^^^  ^^^.  ^^^_^^^^^  ^^^^.^^^ 

uonal  burs^e.  the  ,/«/../""-'''  '"'-"  ^     ^  '!  ^'-,;  .,,  f,n.oris.  and  the  adductor  mint- 

the  nirif..rmis,  the  obturator  mternus  and  semelh,  the 

mus  are  c..vere<l  bv  the  i-duta'us  maxm^us. 

™"  ■  a  .xu-n.ls  tlu.  thigh  ana  i.  ih.  anlaRon.st  of  On 


.  ^,u,aus  maximus  >  -u,,,>lKa  l,y  th.-  inf.ricr  gUUcal  n.rv. 


"'"''^""~  ..        ,  ■  on- ,  is  lis,,  1  strong,  flat,  thick  muscle,  part  of  Nvhich  is 

Th.  glutaeus  mediUS  ,1  .«s.  .<xs,  3.)..       •  1      -^ ^  ;-"';,,;being  situated  in  the  upper  ;-h. 
^,„,^,,,,,d  by  the  ,luln-us  max.mus.  "-;  7-^'.'"'  ^"^    ^    ,  I  ^//Xrent       U  arises  fron.  the  outer 
teal  region  .Hrectly  ..neath  the  gluteal  ^--^      ^^  ^        '  ^H  '^,,uteal  line,  the  iliac  crest,  ami 
,,,faee  of  the  ilium  (Fig.  ...-,  -n  tl.e  -^  '^  ^  '\;;  ;  ,,^,:.,  ^.e  muscle  converge  t.nvanl 

the  p.,s,erior  gluteal  line,  and  trom    he  J^^    ;;;,.,,    ^s  independent  and  passing  obli.,uely 
the  greater  trmhanter,  the  posterior  tase.a.h  bem;.  m-m    J     _  anterior  ones  down- 

■"T""' '::™i:;';;:r;:;!:;;::;:^3r::r::;;^-,t:;:::;i->  -  <> ^- .»- ' 

ward  and  inuaid.      1  lu  slioit  ano  1  f.,.  ns  ihe  tin  of  this  pnK-ess. 

,,urv,  the  />.'>" ^/<'^  /'"rva  »/  ///.  f^luKrus  malms  . !•  .g.  ^o.  K 

,         ,        ,         „, ha,.,  t,,h..lhiKh;  thclawr  anterior  ,K,m.,n  ,,!-.. uls  as 
,,„,  „„,.U  ,.  .u,,,,li.a  1.V  >;u.  ->„.,n.,r  gU.,,.!  -    ;     ,  ^J      '     "  ,^  ..,  i,:'.,f  i„„„,.aiat.  t..na.,n  ana  l.y  a  .l.mKm 

,„,„...-n,ar..ta,or,th,  ,«.>t.rior,K,rt (n  .,>.,  n,lv  .  h,>r,.,  t,  n/,        .         1 

;,„,,,j„„„f„,r,lurO.,Koasan.-M.TnalroC,l.. 

,-       ,o    ,oi    and  '0^1  i- a  Hal,  broa.l.  fan-like  muscle  whi.nhcs 
The  gluteus  mm.mus  il.tr^.    -m,  .,o.,  an  i  ■  °-  „f  „,^.  .^lieula.  tap 

""-  r,  "T'^  •"•  r"  H  :;s;^^;r::;h"::;s:n!.;  :-:•  ^"^ .-  >" '---  ";■  ---'  :-• 

::;::;;:^n;::'i;;;t::;v:,::r--^^^  -"^•■— ^ 

,,„g,u,a.-,„in,nn,-,hU.h,    ,u,.,  .-..,,..„  a  ,o , .' •'  "  "' 

(  iliamtioni  ,  ,  .    1      • 

1       •  t    .!!..      ..>-.;■'    t!'.'.:-:  !;     >.vn!'-!l    IS 

..■  u     ..il    ,r«-\  Ui    jn  1 )  i^  a   uivitie*''**    ;w::u.u   ■       "  •* 


£    2   B 


<3 
•■r, 


O 
■A- 


"  ■'^^'   '  *^^.'^'''''' 


THF.   MX-SCLKS   OF   TTIK   IllP. 


21,^ 


covered  by  the  gluteus  melius  and  minimus,  the  midcile  .,r  main  ,...rt.nn  of  ,he  muscle  .s  d.rec-  ly 
beneath  the  sh.ta'us  maximus,  an.l  the  origin  i>  situated  wi.hin  the  pelvic  c  avUv.  1.  ar,-.  s  In.m  he 
pelvic  surface  of  the  sacrum  a.  the  maruin.  of  the  anUrior  sacral  foranv.na  II  lo  1\  -  tre.|ucn.lv  also 
from  between  the  foramina  or  concealin,-  ihem  .,  and  !,om  ,he  mar.nn  ..f  .iu-  ,n-,  ,,.cr  .  u„u  no,,  h. 
\fter  leavinfi  its  Hat  and  broad  ..ri.i-in,  the  muscle  l,ecomes  M.nuwiu,,  narrower,  pa-M-.  ihrou^^h 
'the  middle  of  the  greater  sciatic  foramen,  beneath  ,he  uluta  u>  maxima.  becon,c.  lendmou.  rather 
abrupllv.  and  is  inserted  bv  a  slen<ler  nmnded  Undon  into  the  tip  of  the  greanr  iroc  hanter. 

The  piriformis  <loes  not  till  die  greater  sciatic  foramen  l)Ul  divide^  it  i.V.o  two  .„mpanmcnts 
which  transmit  both  ^e..els  and  nerves,  the  sciatic  nerve  being  one  of  .evcral  structure^  uhal, 
leave  the  pelvic  cavity  through  the  lowt  r  con      •tnunl. 

Th..  ,,inf„rmi>  i-  u.ullv  M„,,liul  !n  .lir.-.  ,  ...uW^  fmn,  -lu-  -,  i.,...   ,t.  vu-       1.  i-  an  ,  v.,  rn.l  ..,ca.„.      „  , .■ 

lim,  -  |Krf..niUil  l.y  ,.  |,.,rUi.n  ..f  tin  m  iali.  n.  i  \.  . 

The  Obturator  internus  (Fig^.  20-.  and  ;,oo  to  :,02),  like  the  pirifomti^.  aii.o  in  the  true 
pelvi.,  but  U  ,,as.es  to  the  gluteal  region  through  the  lo.er  m  iatic  foratnen.  1  he  tm.sclc  ar,-.. 
Irom  the  obturator  membrane  atid  the  a.lja.ent  surface,  of  tlu  pul.i.  and  ,Mh,u,.,  and,  ,0  a  .cr 
,,in  exten.  from  the  obturator  fa.  ia.  1-  i>  very  broad  at  it,  origin,  bu,  become,  n.arkc.lly  nar 
rower  as  its  tlbers  converge  toward  the  lesser  .iatic  foramen,  in  passing  through  winch  the  muscle 
bends  at  aimo.,  a  right  angle  anmn.l  the  tnargin  of  the  lesser  sa.  ro..  iatic  notch,  the  Mirlacc  duvcted 
,.,,,,1  UK-  bone  being  ten.linou.,  and  reaches  th,-  gh.teal  region,  .here  ,,  .o„n  t.-tnunates  u,  a 
slighllv  naltencl  tendon  which  passe,  directly  to  the  trochanteri.   lo.s.,  where  ,t  ,.  ntM-rtcl. 

Vfter  pasMug  through  the  lesser  viatic  foramen  a,>d  rea.lung  the  poMetaor  M,r  a.e  ol     he 
pelvis  the  inu.le  receive-  two  accc^orv  head,  in  the  for,,  of  the  .lender  ,.null,  he  ,n„rllus 

luprrior  ari.es  from  the  spine  of  the  ischium,  the  .n.llns  ,n,nor  front  the-  tMlnai  ubcros,  y. 
Tlev  are  inserted  into  the  ten.lon  of  the  obturator  internus  ahno.,  tltroughon,  ,h,  ,r  en.ue  K  ng  h, 
so  that  thev  together  with  the  t.ndon  form  a  kittd  of  pennitonn  nn..,l..  XMutv  th.  obtura  or 
iniernt.s  l.nd:  about  the  margin  of  the  leer  .ciati.  notch  th.re  ,.  c^nMantlv  .ttuated  a 
bursa,  the  6»rs.,  ./  the  oblunilor  iul<rnu>,  attd  upott  the  tnu-  I   lu  .  the  tin,  k  .c.tta  nerve. 

,,„.  .,,„„,„,  ;„„„„„.  ,„^„„„.  .„,.  ,!„■  ..n,.ni.  i-  u.ull.   .u,,,l,.,l  t.  .!,.„  ..„„.,„..  „ ,1,.    -n --i  fi-u- 

l.ikr  ill.   pirif..Mni,.  it  i .  .in  .  xl.  rn.il  ...i.c.or  ol  llu-  ilii^li. 

Th,-  quadratus  femoris  d- ig>.  ..,.  and  ,o.  li.  a  Hat,  thi,  k.  r.itangular  mu..  k- .ituat.d  in 
(,..„, f  „u.  glu.a-u,.  tnaxinn...  I-  an.c  frotn  the  out.-r  b,„d.  r  of  the  tub.  ,o.,.y  o,  the  wihunn 
^,d  in.crt.  L  a  .ho,-,  tendon  into  the  inte-t,-o.  hanteric  tidg.  .  The  upp.r  tnargtu  ,.  the  nu..  - 
i,  in  nntncdiate  relation  wi,h  ,h,-  ..  tnellu.  mt.-rio,-.  and  the  k.w  r  n,a,-.,n  u„h  tin-  „ddu.  ,,.  n  n 
nu,..  r.ually  betuath  the  .,uad,,atu.,  or  in  the  grouv,-  betuien  tt  and  th,-  mntellu.  ,nl,-M,„ .  ,u,,. 
die  obturator  extcrnu.,  upor,  whi,  h  li,.  th,-  s>  iati,  mvw. 


■llu    .|,l.nll     --I-   I' 


,,1,.  ,ll„  i!„.  Mi.iii,   n.  r>>        ll  i-  an.M'-rn,,!  i..i. i  lii.-ihu'li 


The  tensor  fasci«  lat«  -I-'ig..  ..,  ami  ...o,  i.  a  tl.it  ,lo-u:at,,l  nm.,1.  ,  nart-,iw  ab,.,-  atul 

,,      .  .1 I... ..,■  ,l„.  r,,.  ;.,   Inlil    i.,-,'  D.IL',-  J  ; 'I  in  tiu    U],p,  I 

broad  iieiow.  "in,  h  I- .Mu,.i,  !  ll,;-*, -  •    ■■'.'.■  ,  ,i   ,   ,   ,,  i,,„  i-,.,,m 

,,„„,,,  „..,.han„-ri,,  an-l  .-M.rnal  femoral  r.-.ion.       I,   aii.,.  bv  ..  ^hort   an.l  .kit   nndon  bo,n 


^ . 


214 


ATI.AS    AND   TKXT  «OOK    OF    Ul  MAN    ANATOMY. 

rC  .;.,1  1  ,v..r  of  mu-^clvs  „f  Ihc  anterior  surface  of  the  li.ish. 
I-  IG.  207--  ril-  m"^^  '^^    :;.,,,,  i„^,,i„,,  |iK.,„..,U  h...  als..  be.-,.  r>move<l. 


,1  ,,.rv,-  10  in>  K.iM'  tlu-  I.  iisi.m  uf  the  fascia  lata. 


).() 


Till.-  mu 


«l^^^u,.,.l..al>^•th,■^u,.,■ri.,r^luu,am■rv,■ami 


THE  MUSCLES  OF  THE  THIGH. 
THE  SARTORIUS. 

.„H.ri..r  surface  of  fhe  thi^h.  ttt.i  is  U.    -n..    ;— ^  ^  t'  ^  ^-^  "^  ^'^^^  ''''''  "^"^^'^' 

superior  ^,,ine  of  tlu.  iliu.11  m  co.iimon  ^^ tth   he  U ">"■    '^^  '  j,^^^ ^^^,,  ^.,,1  ...vnwar.l 

U^omes  eonsiclerahlv  i.roader  for  a  short  thst.UK.  ;  ^  ^^^  ^J  ^,,^.^^^  ,,,  „,,,,,  ,..,.,.. 
U-low  the  iliopsoas  ami  u,>ou  th.  upper  portton       '  '  _„.,,  ,„,  ,,,hes 

U..  va.us  tn.,ia,ts  ami  the  ad.lu.  ---   ^^  '^'t      ^     ^.a.iou  \.    gradually   U.eo..es 

,H.  lower  ,.rtiou  of  the  -'-V  ^  't^^ras  anterior  in  the  upper  portion  of  the  thi«h 
narrower  and  ts  ,w ts  ed  .  ^  '  ^^^  \,.,^i„„  ,,„,u.  the  outer  (anterior,  niar.ni  o,  the  ,ra- 
n,nv  iKeonus  nnernal.     It  tlu  ti  laKCs  up  a  ^^^^.^  ^^^^^^  ^^^  ^^^^,^, ,,,  „,^.  ^^^^,,.. 

"",. ■ ":,'■- "■" "■■•" ""°'""'"' 


THE  MUSCLES  OF  THE  ANTERIOR  SURFACE. 


THE  HUSCLna  ur  ir...  ~ 

•.1„.  quadriceps  femoris  iKis*  =*>.' --'A  .l"' •'"■^^^^^^ 

T,,,  rectus  fcmorls  ,1..^>.  •*  ■"  -'*'  '";."':;.;„,,,,  ,„,, ■i„„„„li,mly  I,. .,,,,.1,  .1..- 

t':,;;;;:;;;.  .is::;;;::::,,,;  1.™  a,,,, «.» ...^  --^ "™ »- "- ^^  ■""- 


*riii'  ,,irliiriii>  a 


.lv,|«.-,s,'-     ,lh.-l.>iW-t  MUl 


iM  iilar  (a^iUuli  in  lli'-  I""')' 


Anterior  super, 
spine  of  iliu;n 


Tensor  _  „. 
fasciae  latae 


llicitibial    ' 
baud  of  fascia 
lata 


-^     Prontontory 

Unrtorius 
Tensor  fasciae 
Piriformi<i  InUie  ■ 

Olutaeus 
Inguinal  media'- 

ligament. 


Tnhcrosity  of  tibia 


—  Adduaoi  magniis 
•i-  Graciii'- 


I  'aslas  laterali 


Tendon  of  sarlorias 
Tendon  of  gracilis 


Tendon  of 
semitendino^us 


Sartorius 


Svm/ihyseal 

surface 

of  pubis 


Adductor 
magnus 
Adductor 

conal 
(femoral 
vessels ) 

Gracilis 


Fig.  2Q6. 


Fig.  297. 


■jr 


a 


""'-Jf^V 


■.?^K 


THE   MUSCLES   OF   THE   THIGH. 


-M^ 


itself  while  the  other  proceed,  from  the  up^er  margin  of  ihe  aeetaln.hnn  an<l  ,o,ns  the  on„n  lr(,n, 
the  anterior  inferior  spine  at  a  right  or  obtu.e  angle,  the  two  together  b.  .ng  eon,.nue,l  .  ownwar.l 
a,  an  aponeurosis  upon  the  anterior  surfaee  of  ,l,e  nn.sele.  The  I'.ber.  o,  the  n.Useie  -io  not  run 
lon^Mtu'linallv,  hut  diverge  downwanl  and  haek.ard  touard  ,he  in>er,>on  iron,  a  .end,nou>  s,r,,, 
in  ;lu.  mi.ldk'of  ,he  nn»ele.  The  Hat  ten.ion  <,l  in>eni..n  .onu.Hnees  up'-n  the  anterior  a.peel 
of  the  museular  belly  a  few  eentimeters  above  the  i>a,ella  and  uniu.>  wuh  tl^e  rc.nanung  head.  ,o 
pass  to  the  ujiiier  margin  of  this  l)one.  ,      ■,      ,    i 

The  vastus  medians  unUmus.  .Fig^.  ...(.  to  ..S.  i^  a  large,  llat.  dn.  k  mu..  le  Mtua.ed 
the  anterior  and  internal  femoral  r.gion>.      h.  origin  is  from  the  inner  lip  o,  du-  hnea  a.,  .  ra  o 
the  fenu,r  where  i,  i>  adherent  to  V  .    insertions  of  the  addue.or.      hs  ,    k,.  run  downuani  and 
fonvanh  .ome  of  them  being  inserle.l  into  the  upper  n^argin  of  the  patella  v.d,  the  eonuu<.n  ,en 
,l„n  and  some  of  them  passing  in.lepen.lendy  to  the  inner  margin  of  .h,s  bone.      I  he  greater  por- 
tion of  the  musele  is  situated  in  the  lower  thi-d  of  the  femur;    its  outer  uu.rgn,  r.  tuse.i  wuh  .he 

vastus  intermedius.  .  n      .  i 

The  vastus  lateralis  irxlcmu. .  ,  F'g^.  .<;<-  --'  ^-.S.  ^oi ,  and  ,,o. )  »  an  unusually  strong,  large. 
,lat  mu.sele,  whieh  forms  the  ehief  bulk  of  the  museula.ure  of  the  external  lemoral  o.non.  1.  ,. 
stn>nger  than  the  medialis  and  do.,  no,  exten.l  as  far  .lownward  as  ,h,s  nu.sele,  ...ng  h  uated 
chielW  in  the  upper  and  nud.lle  thirds  of  d,e  llugn.  I.  arises  from  the  outer  hp  o.  d,e  hnea  as,.,a 
as  far'  upward  '.s  the  great  trochanter  and  ,o  a  eer.ain  extent  Iron,  the  ou-r  pon.on  o  d,e  ia„e 
prominenee,  and  its  libers  run  <,ui.e  obliquely  from  behind  forward  and  Iron,  aUne  downward. 
the  direction  of  the  upper  fasciculi  apjiroaciiing  the  vertical. 

The  entire  -xternal  surface  of  the  m.r.cle  is  covered  by  a  broa.l  aponeuro.,.;    ,N  inner  mar 
gin  conceals  the  greater  portion  of  the  vastus  intermedius.  wid,  win.  h  i,  w  inseparably  connec,.., 
an<l  it  is  inserted  bv  means  of  the  common  tendon  into  die  upper  an.l  outer  margm^  .)l  die  patella 
The  vastus  intermedius  icrurrus^  iFig.  .„S.  i^  a  Hat  muscle,  the  ant.nor  surlace  o    w  n,  h 
is  tendinous  and  distinctlv  excavated  ,o  a.rommo.late  the  overlving  rectu.  lemons.      1.  ,-  ,l,e  leaM 
independent  of  all  the  heads  of  the  Muadriceps.  since  'ts  lateral  margins  are  inseparably  co.n.rol 
.ith  the  other  two  vasti.      It  arises  fn.m  almost  the  entire  length  o,  the  anterior  sur.ac  o,  die 
shaft  of  the  fennir.  and  its  libers  pa.,  from  behind  downward  and  forward  mto  die  anlerioi-  ,en 
dinous  surface  of  the  mu.cle  and  .ubscMuendy  in.o  the  .ommon  tendon  ol  die  ,|uadriceps.      1  he 
lower  fasciculi  of  the  vastus  intermedius  pass  to  die  join,  an.l  a,v  known  a.  ihe  m.  .ri,.ul„r,s 

rhe  ...mmon  lend.ni  ..f  insenion  ,.f  ,he  four  lua.ls  of  ,!,.■  MUa.lri.vps  ari>.s  imm.-.lia,.  v  ab.,ve 
the  pa,ella  bv  ,he  union  of  du'  ten.lon  ..f  ,he  rectus  wi,h  ,ll..se  of  ,lie  vas,i.  I,  embra.  .•.  ,!,.•  entire 
upper  an.l  ,lie  la,..ral  margins  .,f  ,lie  pa,ella.  ,he  la„er  s,ru.  ,u,v  simply  serv  ing  a-  a  ..■samo.,1  bone 
f.'r  the  ten.lon  which  i.  c,.ii,inu...l  ,o  ,he  ,ulHn.si,v  of  ,li..  ,ibia  a.  die  i-au^llar  hganu-n,  (..r  pag.^ 
,,,5).  The  actual  point  of  insertion  ..f  the  .lua.lricep.  i.  c.,nse.,uen,ly  d>i.  rough.n.-l  pro.....  ot 
the  tibia. 

•I-l„.  ,,„,„lri,,.,.s  i^  >u,,pli..l  1./  tl--  l."-.'l  —       '"  -'-■"'l"-«  ""   l''^  *'  '■''""-  ""■  I''"'"' 


I: 


ATLAS    AND    TEXT-ROOK    OF    HT'MAN    ANATOMY. 

Fig    -oS.-Tlie  .icq.  lavtr  of  musdcs  of  iho  ^interior  surface  of  the  thigh. 
Th.  iii,,,Las,  sartoriu.  r.aus  f.moris  ,,.-.n.KU..  ad.lu.l.r  lon«us,  an<;  graul.s  have  been  rcmov.-,!. 

Fir    -GO  -The  insertion  of  the  iliopsoas  and  the  origin  of  the  ol.turator  externus. 
Th.  a-Ulll^U.;'";...  t.!^  "ivi,Ud  an.,  r..,,,.,.,, '  ,.,.  f.nu.r  ha.  W,n  .a.v„  ,hr„u.n  ...  ,w  th.  tr.nha.U.rs,  and  ,. 
sHchtlv  Ik'Xiil  anil  rcitateii  outwanl. 

Fig.  300.— The  origin>  of  the  piriformis  and  th.  ohuirator  internus. 
Thi-  pelvis  h.i.s  livvn  diviik-il  in  llu-  mc'<lian  l.nc. 


THE  INTERNAL  OR  ADDUCTOR  GROUP. 

Tho  muscles  of  this  ^roup  ari^e  from  the  pul.i>  ar  1  ischium  in  such  a  way  tha,  ,hev  forn.  a 
series  of  rin<^s  ahou,  the  ol„uraU.r  foramen.  The  outermost  ring  is  forme<l  by  ,h.  ol,tun,'>, 
exnrnus,  the'middle  l.y  the.  M,aor  /-nr/.v  an.l  mhw.us.  and  the  inner  by  the  !>,rlnuvs,  the  Mu- 
tor  hn^m,  the  ,i,'n"  ///.v,  and  the  nddiuWr  mapius.  ,      •       .    1  ,    ,„.,.,  „ 

tL  pectineus  .Figs.  .oO  and  ..;,  is  a  llat,  -trong.  .t^drangular  muscle  suuated  between 
the  iliopsoas  and  the  a.lductor  L.ngus  in  the  subinguinal  and  anlerior  femoral  reg.ons.  and  form- 
in.,  to.'ether  with  the  iliopsoas, , he  iliopeCineal  h.sa.  h  arises  from  the  ., est  o.  the  pubis  a.  Ki." 
fc;.vard  as  the  pul,ic  tubercle,  passes  ..bliquely  fron,  above  dovvnwanl  and  t,-om  within  outw.ird, 
.,nd  i.  in.erte.l  bv  a  short  len.lon  int.,  ihe  pectineal  line  of  the  femur.  1  he  i.tser lion  ,s  parH, 
conceale.1  bv  the  iliopsoas,  covei's  the  obturator  externus  and  the  upper  pan  of  the  ad.iuctor  bn  Cs, 
and  passes  over  the  inner  siirface  of  the  articular  capsule  ot  the  hip-Joint 

TlK.  ,„.,  ,in,  u.  addua.  .he  ,hi«h  and  als„  a.i-t-  iL  xi-.n.      1.  i^  -upi'li.  ■!  '-  '1-  ..'--t,,,-  and  fen,oral  nerves. 

T-he  adductor  longUS  ^Mgs.  ,^u  and  .07.  i>  a  thick.  Hat,  almost  triangular  truscle,  situate.! 
,..,ween  .he  pectineus  ait,!  the  gracilis,     it  ar,.-.  bv  a  rather  naiTow  In.  .hor.  ami  strong  te,.do. 
1,  ,he  sup  rior  puwic  ramu.  between  the  origin,  of  the  pectinetis  and  gracilis  b^conjes  decidedb 
"  uler  as  t  passes  downward,  an.l  i^  i,i.  rU..i  by  a  ^hor,  icn.L.n  in-o  the  mi.l.Ue  ihinl  .     .he  inner 
he  lin  a  a.p..ra.     The  hb.is  ,d  .he  mu.le  pursue  a  direc,i..n  siiiular  ,0  .h.^sc-  o.  the  pe.  „ 
s      though  th  V  run  m.„-e  ,lii-e.  .ly  .l-wnwai-.l.      If  ,he  muscle  i>  w.ll  de.  op.-d  ii.  upper  mar^ 
;;      i;  imm..dia,..i;  ..,n.i,ti,otis  w„h  ,he  lower  margin  of  .he  p,c,i,t.u.  a,t,l  wl,   e  i,  .s  .,uaU.d 
b...we..n  .he  p.  e.ineu^  a.t.l  .h..  g-'a.  ills  ab.ne.  i.~  L .wer  p,.i-ti..n  I.es  up..n  .he  a.l.lu.  .-    magm,>. 
1  ic    is  exp.le.l  between  .h..  a.l.iu.„.r  longi,.  aivl  ihe  gra.  ili.     Tl,e  upper  p.,r,,.,n  o    the  i,   due - 
„„.  longtis  lovers  the  a.l.lu.tor  bn  vi.  .he  lower  .he  addu..,..-  n.agnu.  u- .en,  on  .-  in--e    :     J^ 
,„nceale.l  bv  the  sir...riiis  an.l  i^  a.ih.T.n.  .0  ,lu-  ...gins  .d  .!,.■  Nas.u>  mciah^  (se.   ,.ig.   -is>, 
;:;X  ut 'h-  -.^.1,0  sar...riii.  an.l  ,h..  iiiguinal  ligam..,.,  .he  ntuscle  forms  a  .rtangle,  the  le.oral 
tr'miii^^k  (triangle  .'f  Scari.ai. 

The  a.ldu,  .0,^  luni:u.  i^  sunphed  l.v  ih,-  ul,u,r.„.,r  nvrv.  ,    ii  addua-  the  .h,uh. 

The  mcili.  .Fi.'.  ..,71  i^  a  long,  thin,  slemler  mu.de,  .i.ua,.-.l  i.pon  .he  inner  aspe.l  of  .he 

1  lie  gracilis.      I.,.  -  ;,      ^  -    ^^        ^    ^_ ^_  ;.,,•,.,.;.„.  r.,nu  ,,i  ihe  nubi-  near  .he  svm- 

|hi"h.      It  ari-e-  i)\  a  ilai  . .11, i"n  ironi  .iie  :U|Tt.. :■.!■,:,  •,, ,,      i  „       ;,„•„, 

Hv^i,  be.„m,..  -m.vhii.  bn.a,l.r  a.  .k>.,  but  s.,.,n  narrow-  a.i.l.  ,u>t  ab„v..  the  k,ue  ,o u  .. 
:  ■s.-Jinio  a  long,  r.,und.  .l..n.U.r  .en.l.nt  which  runs  t.,  the  inn.r  bonier  ,d  ,h,.  .ubercl..  o.  .he 
liljia  and  radiates  inf..  the  />,  v  anscrinn.  as  .he  secon.l  .eii.ion  .d  .ha.  Mru.ture. 


Sartoriiis 


I lio pectineal  bursa 


Iliopsoas  < 


^-^       Siicrotuhrrous  ligament 
*  Adductor  tpn^iis 


Obturator  externiis 


Addiictiir  brevis 


Adductor  opening. 

Tendon  of  adductor 
magnus 


-  Semimembranosus 

Obturator  canal. 

Internal  intermuscular 
septum 


Tendon  of  sartorms_       _ 
/  endon  ofgradlis  ■ 
Tendon  of  semitendinosus 


Pes  anserinus 


Sartorial  bursa 
.-\nserine  bursa 


Fiff-.  299. 


Adductor 
longus  ■ 

A^ymphyseat 
lift  surface 
I  I  ;  1  (>/'  pubis 

Piriformis 


Coccvgeiii 


Sacrotuberous 
ligament 


Promontory 


Si'cral  canal. 


Sacrotuberous  ligament 


fifr.  300. 


rig.  20S. 


■■^'■1 

T^ 

i 

i 

1 
1 

; 

\ 

s! 

11 


THE   MUSCLES   OF   THE   THIflTI. 


21' 


TK  musck-  is  Mn.plicd  hythc  obturator  m-rv,-.     \Vh,n  ih.  kn.     i-  rsl.n.l,  ,1.  il  a,l,lu.t-    hv  tliiL'h  ,,.,.1  ..-i--.-  <n  i!u 
flexion    ,f  'he  kill'-'  !.. int.  and,  wlun  thi-  knn-  i>  fli'xcil,  tkv.iU-  iIu  '-t;  lUA.iril 

The  adductor  brevis  (Fig.  pqS)  is  a  long,  broad,  rathrr  tbic  k  muscK'  which  i>  uiuur.l  m 
the  midd--  lavir  of  the  adchictors  (t,chind  the  i» rtineu-.  ami  addiulnr  lon-n-,  Imi  in  In.m  -;  ilu- 
adductor  inauniis).  Ii  i^  longer  than  the  pctineu.-.  >horter  than  ih,  addiutor  longvi-.  .'.vA  i~ 
usualK  .omi'.letulv  .oncealod  by  these  two  ntu^ele..  It  ari-.e>  from  'u  >ti,.enor  ramus  .A  thr 
I)ubi>,' nean  .  ihc'obturai-  -  foramen  thnr  the  ad.ltutor  l(.ngu>.  an.'  ,t-  libera  imr^iie  a  c...,u>. 
similar  to  those  of  the  lai  r  mti~-  k;  but  nni  m.  nbli(|ue,  t..  the  ui-ik  r  third  ..|  the  inner  lip  ^  i  the 
line;!   aspera   of  the  femur. 

•[•|„.  ,„  rvi— up|.lv  .incl  the  fund:,  i.  an-  i.^.-.  iliusr  .     \hr  .ul.l    .  l<.r  liini."i- 

The  adductor  magnu?  .Figs.  2<)(^  to  2()S,  ,^oi,  and  ;,02)  is  ■;'-  stnnv.  est  of  the  addtuK.rs. 
It  forms  the  deei.e.-t  layei  .nd  i-  Mluate.i  most  ;.o>terior!v,  arisi-i-  from  tli,-  inf.  r  ,r  ,.ubic  amu^ 
and  from  the  km.  r  bo'rd.  r  of  '  'e  luSenoiiy  .,1  the  i-  am.  In  np|-.  r  liber^  ;.a»  bi,'  dighliy 
downward,  the  middle  ,ire  more  oblique,  and  the  lower  an.i  anermnq  liber-  pursu.  m  alm..^ 
vertical  direction:  the  upper  and  middle  libers  i.as.-,  behin.!  the  a<l.t  utor  l.-igus  and  brevi>  l,.  a 
muscular  or  short  t.ndinou- insertion  int..  .e  upper  t\\M  tl.ir.l-^of  ■  •  iiuur  hp  of  ti;.  linra  a-pera  . 
the  lower.  alm...t  xerli.al  liber^.  l,owe\,  :,  pas>  mlo  a  round  ^1^  .ler  ten.l.m  whu  h  run^  lo  th. 
lowest  portion  ..t  the  linea  aspe.  and  t..  'he  int.  nal  ej.i.  ..n.lyle  nl  the  lemur.  .\l  aN.ut  the  lower 
third  ui  the  Ihigii  this  insertion  eoni,.in>  an  el..n..;ated  orilae.  kno'.vn  a>  \hr  l,n,Inwii^  <uUlw lor 
opcnin-  (Fig.  298),  which  ha>  ten<iinous  boundaries  ;ind  give.-  passej.   I'l  1'      lem.     d  vesseK. 

Between  the  tendin.uis  origin  of  th.    va-tus  m(.Hali~    .■..!  th.      aort  i   adinou-  inserliu..,  ,,f 
the  adductor  brevis,  longus,  tml  ma.rnus.    acre  i.--  a  deej)  ur.-ove  .Ahich  i-    ..nvert..J  into  a    .mal. 
the</(/(/»rtor  iHlinUr-^)  nmal,  In   die  sarl..riu-.      li  coniain-  th.    femoral  -.es.eb,  .uid  the  len<li 
nous  libers  of  tjoih  group-  of  mu-.  les  are  interw.,\en  in  ihis  situation  !■■  form   >  liiirou-  va,-.  idar 

sheath.  . 

While  the  gre:.-.T  porti.m  of  the  anterior  -urfa,,  f  the  ...l.luct..:  magn--  is  .(.\.  r.il  1,\  ihe 
adductorl.mgusandbrevis.  it-i-o-ierior-arla..  liesup.  nth.  ll.A.,r  .nusc  1. -,  a)  i  it  is  .  ..n-e.|Uently 
-iluated  between  these  tw,,  -,  ts  of  mils,  i,  s.      Hie  m  i.itic  nerve  li.>  upon  it-  p..-teri..r  -urta.e. 

The  adductor  minimus  il'igs.  2.>;.  .^oi,  .^02)  1-  a  small,  llal,  approximat,  K  quadrangular 
muscle,  which  fre.iu.  :niy  appear-  to  be  -imi)ly  '.la  up;  •  .  p..nion  ni  ■he  ..  huL..  nagn  :>,  with 
which  il  i-alwavsdir.-.tiy  ...nlinuous.  It  ari-<-  from  iii.-  inf.  a.r  pe-a  r,mus.,i  in.m  ili.  juiu 
tion  of  the  infer!.. r  rami  of  ;h.-  pnbi-  an.!  i-.  itium,  il-  upjicr  liber-  1..  in'  Im..  hori/...Mial,  ,inil 
running  below  ,di-tali  ami  i>arail.l  ■  .  ihe  .|uar!ratu-  Umori-  ...v.  aigin  :  u'u;  ..rm.iM  ^il..!;.  .,f 
the  adductor  magnus  from  behin.l .  to  be  insert.d  int..  ihe  upper  .  a.l  .)f  i  f.aii  r  bel..u  'i'.  -real 
trochanter  ami  be-i.le  the  glui.a!  liib.r..-ilv.  It-  k.,ver  liber-  nn;  oblLiuely  .|..wnwant  .1  are 
in.serte.1,  t.igether  with  th..-.>  ■•i  the  a.lductor  maL'nu-.  ii.io  the  pper  Mremi'  ..f  the  raier  lip 
of  the  linea  aspera.     The  sciali.  nerve  lie-  also  upon  th.    ,.lduct..r  miiuinu-  (-it  .M-e  21;. 


I'll.'  a.l.lu.ti.r  ni.innv;-   ili.i 
Thtir  .itUi)n  is  -imil.ir  t..  lli.it  >>i 


i!iiu>  ai'   .  .Ill  in  -..pe 
iitllcr  ail.l.-Hl.il'--. 


:,;ur;K   r  nvr\v  .lit-: 


Th.'  obturator  externus    .  igs.  2^,S  ami  2    ,■  belongs  to  the  ad.huM-    -;roup  .mly  ..n  acmni 


£-iM^-'' 


i 


i^\:. 


m 


2j8  atlas  and  tkxt-book  of  human  anatomy. 

F,o.  30.. -The  d.ep^layer^_of  the  posterior  hi,.  n,u.dcs  and  the  su,.cr«c1al  layer  of  the  Oexor.  of  the 

•nu.  «luu.us  .SSr^llnH-lius  an,l  ,1...  „...ura,„r  ''^^^■'';''' '^;;r  ]CaZuL  of  the  rtexors  of  the  thigh 
F,G.  302. -The  .lee,,  layer  of  the  posterior  h.p  muscle,  and  the  .kt,.  l.ucr 

region.  ,  ■     ,1,    i„ni,  !„■  1,1  ..f  thi' hiirus,  ami  thu  srmiti-mlinosus  haw 

Th>-  Rluta-us  maVimus  an,l  nH-.li.>,  ih.  .,ua.lrau,s  f.muns,  ,lu-  lon^  h.  a.l                     1    • 
b«n  rinioviil. 


.„,,  ischium  »,1  is  .,™,,k,dy  ■,.vm-.l  l.y  ,  .■  1"  ;""'-     'j'       ' ^  ""\i  .  ,„„„  ,h,  i,,„i„„,, 

,  ,„,„,  ,„  .--;;»;*»;„„ :  — r^rn.:^:;:":;;!  -„.  ,„ ... .... 

chanter,  and  i.asse>  n\cr  and  i.c  n.nd  ur  ,.„v(.red  hv  the  latter  muscle,  to  the 

^xr^:rr*:;:t;i::s.t:;:Jr^  -" 

dinous  a  short  distance  before  its  insertion. 

The  „„U..U.,r  >..U.n,u-  i,  sup.li,-..  i,v  -h,-  ,„„ura,.,r  n.rv,..     I.  a- ,.  as  an  eternal  ...a... 

THE  POSTERIOR  GROUP.  THE  FLEXORS. 

,,        ,  1      th,. />;,,  fts  ;Vm(>r/v  the  .'"■m//()i(//»<>';i/v,  and  the  srm/- 

-i:s;i:;;::r;rpri:';;t:;:«^^ 

hulf'.f  the  outer  lij.  of  the  iineaas]Kra.  ,.,,.:,    ,h,.  ,K,sterior  surface  of  the  lon« 

„ ,^:^;:r;:i,;i;';;:::^^^^^^^^^^^^  - '- 

„„.  ,:■  ;:;;;::;;;';«;;.r'n;:i:  ,;':,l;:i,;  „; -.,.. < -  -■ 

lH.]ilileal  fossa  (see  page  2.-0.. 

„„,„n,hea„.,t.he  ,.„.,,  i .,..,....,.  ,h,0.„.„  ,  .he  .„.Oh,a,M.  ,.„.,.,. a,,„ne. 


S,icroti:herous  lig. 
Sacrospinous  lig- 
Obturator  internus  x   / 
fiiirsa  of  obturator  int. 


Tendon  of 
■ifmitfiidinoiiU'^ 

Trndon  of 
si-mimemhranosiis 


I rndv'i  ''''  i^iiljra- 
tor  iiitirnns 
MiilJIr  '^iutM'i 
hui  v(  >' 

jlntaeii  s  incdiiis 


Hiiv/i'i  fi'iioris 
(short  heiiit) 


Irrtdon  of 
Iticrps 


Itndon  0)    ^ 

simimtm- 

branosus 


Oemellus  superior 
Gemellus  inferior 
aiutaeus 
medius  - 

Qiuidratas 
fimoris  ■ 


llinii:i  femons 
Inni'  head) 


n,   m 


lie  WJ. 


.T> 


^iH 


mijj-:L^r^;,khs. 


S.:^i£<ji 


THK    MTSn.F.S   OF    TTIF.    I.FC. 


21Q 


head  Of  the  biceps,  although  its  tcrdon  ^s  sonn.vhal  sho,,c.r.  and  .ts  muscle  porfon  rcquenth 
exhibit  Ttendinou  intersection.  In  the  l-.ver  fourth  of  the  thi.h  U  ,,as>.  .  .n,o  a  c  yhndrual  ten^ 
don  which  is  insenci  into  the  inner  surface  of  the  tubercle  of  the  ..l.a  and  .orm^  tl,.  .o..nK,st 

tendon  of  the  pes  anserinus  (^iS-  2q8)-  ,,n.i,en.lino.u>  form!,,,  the 

The  three  tendinous  i-xi.ansions  ot  the  sartonus,  i^iaciii..        i  ,•,,.,, 

uesans  rinus(Fi,.  ..,8.  are  peculiar  in  that  they  form  fan  hke  ra.hat.ons  Intween  whul  are 
Su2rt^nu.mbranes.  The  broa.l  ten.iinous  surface  of  the  pes  anseru..  ,>  separated  .rom 
ttlX:Z^^ns.rn,c  l...rsa  ,Ki«.  .,<S,.  In  a.l.li.ion  to  it>  attachment  to  the  t.b.a,  the  pe> 
anserinus  is  also  intimately  connected  ^vith  the  crural  fascia. 

Th..  .■,.....n.l.n..us  i,  >u,,,,iu.a  l.v  .h.-  til,i„,  n.rv..      1,  IVm<  -i.-  W,  and  r.,,.,,.  „  ,n.anl 

The  semimembranosus  (Fi,.  ^on  i>  a  v.ry  pe.uli.r  mu.le.    Its  up,.r  ^^^jf^'uiZ- 
sistsof  a  Hat  membranous  tendon,  then  follow,  a  tla.  but  wry  .huk  muscular  belly    whu  h  Ima 
aim  nates  at  its  insertion  in  a  llalt.ned  round  tendon.     The  ma.k-  ar,...  Irom  the    ube-oM' , 
"r      hi   m    in  front  of  the  Ion,  hea.l  of  the  biceps  an.l  the  s.mi,end>noM.-,  by  a  .b,  tendon 
:    ';  ^Z.:..n  the  posterior  surface  of  the  adductor  ma,nu.  and  .i'-^".-!;;;-;"  o  tl.  s.n. 
lcn<linosus;  upon  the  outer  side  it  extends  .lounward  a.  far  a>  the  nuddle  ol  ,lu    tin^h.  uh.k 
sZwh  t  i.rter  upon  hs  inn.r  aspect.     Fron,  .his  undon  ar.  ,uen  ....  muscular  tascuuh 
l^ri^    from  alH.u.  downward  and  from  witltou,   inward,  and  Ikcohu.  ..nnmun.  .„     a 

^  rlded  t..ndon  .tuated  t.pon  ,h.  inner  ..l.  of  the  •"-^'--V''';;:";;;!;  ".':.::  1  r 
„f  „,,  thi.h.     Thi-^  tendon  of  in.r.ion  passes  to  the  n,ternal  tuber,  le  of  the  tib.a    ,.  >nudl  p.  , 

.'    a    i^aes  into  the  obli„ue  popliteal  li.amen,  ..e  ,.a,.   ,,.,,  an,l    .;  ..be.  ^''^  '-  •-- 

orh   to  the  inner  n,ar.in  of  the  tibia.      Heneath  the  ten.l.M.  ..,   the  s..mu.u  ,nb,an..sU.  tin,.  .. 
Z!ue!l  a  bursa  which  communiea,e>  with  tlu  knee-j..int.  the  l.rs.  o,  ,l,r  s.  ,un,u,„l.r.u.s,.s  .see 

'"'Viule  the  upper  portion  of  the  >emimembrano>t,.  i.  M-uat..!  in  fnu,,  .,f  -h.  -->-'''--;; 
„.,  L  lon«  head  of 'h.^  bicep>.  in  the  lower  ,hir  1  -f  the  ,h„h.  ,  .-  nu.,  1.  h.-.  m,..rnal  t..  the 
biceps.  t..«ether  with  winch  it  f.-rms  the  u,,per  Ix.un.lary  ..f  liie  !„>ph..al  .o-s,  ,mv  IkIo.v  .. 

,-,„.  n,.rv.   .„.,U  ..,,..  ,h,   fun,  „ I  -l.   -.  nun,,  ,nl,MM,„u.  an    ..n„l„  ■•,  .1..- .m  n,| ■„     an,l   i,    a... 

.„u  as  a  t,ais.,r  ,.f  lllr  tai.-ular  li«anu  nl  ..I  llv    t-n. .    I„.m 


THE  MUSCLES  OF  THE  LEG. 

THE  MUSCLES  OF  THE  POSTERIOR  SURFACE.    THE  CALF  MUSCLES. 

The  muscles  of  the  po>teri..r  asp.c,  of  the  le«  ,  Fi,.  ^o^  .o  ,o;,  a-"""i";  '''";;;;;  '^^   ^;; 
a  superl-uial  laver  forme<i  bv  du.  /nV,  /n  su.r,  and  ,.  deeper  lav.r.  n.n>...m«  ..   in  /../■/""-  •' 
,„,lo(  tin-  libiali.  po.Urinr:,hx,.r  l,.,l.,ui.  hw„<^,  and  //rv.r  .//,■'""•"'"  /"".^'"^  ^u^. . 

THE  SUPERFICIAL  LAYER.  THE  TRICL  'S  SURAR. 

.-    :.i    i:  ._.;.  ..I.,-     ,M,I    l.liiiiilal    iKirtion.   till'    i,"'*''"'" 

The  triceps  sure  »"ii-i--,-  "•  a      ii.rni.n  -r..-.:- 

mm/«v,  and  .'f  a  d.TiHT  m.mariiMilar  p.)rtion,  liu'  M'/c/(^.  ...  . 

The  gastrocnemius  ,  Fi«.  ,o.V  i>  a  .lat, .  I..n..ate.l.  .lis.inctly  bi,  ipUal  an-l  verv  Mron,  nuH.  le. 


"s^^mmtm^^ms:.  vts^^. 


i  \ 


t    ! 


2  20 


ATLAS    AND   TEXT-BOOK   OF    HUMAN    .\NATOMY. 

Yic  30^.— The  superricial  muscles  of  ■.'tc  calf  of  the- leg. 

Fic    504  -The  second  laver  of  the  calf  muscles.     The  gastrocnemius  has  been  removed. 

P,(,  '       _xhe  deep  musculature  of  the  calf,  seen  from  behind  and  from  the  inner  side. 

Thi.' iriups  sur:i- has  luin  rcmi.vi-cl. 


which  is  situate!  upon  the  ].(.stcri<.r  aspect  of  the  knee  and  leg;  its  muscular  belly  ,s  s.tuated 
chietlv  in  the  sural  region,  ^^hile  its  tendinous  portion  is  located  in  the  po.stenor  crural  region. 
The  two  heads  the  inner  hnul  .^aslroawnuus  miJu.lls)  and  the  oulcr  head  (aastrocnamus  laler- 
alh)  arise  bv  tendons  from  the  upper  extremities  of  the  epicon.lyles  of  the  femur  and  exhibit 
aponeuroses  ujK.n  their  internal  and  external  surfaces,  extending  <lownw.-  d  almost  to  the  muldle 
of  the  muscle.  Beneath  the  somewhat  stronger  inner  head  is  >ituate(l  a  bursa  which  communi- 
cates with  the  interior  of  the  knee-joint,  the  inmr  ^i^.islrocncmial  bursa  (Fig.  304)  (see  also  page 
n6)  Both  heads  of  the  muscle  pass  immediately  over  the  ].osterior  surface  of  the  knee-joint 
furmin-r  the  inferior  Ix.undarv  of  the  popliteal  fossa,  and  below  the  articulation  they  become 
broader  ami  are  united  in  such  a  manner  that  their  line  of  union  is  indicated  by  a  median  groove 
which  extends  almost  to  their  insertion  into  the  common  tendon.  Somewhat  below  the  middle 
of  the  leg,  the  muscular  tissue  terminates  rather  suddenly  in  a  broad  tendon  which  becomes  nar- 
rower and  fuses  with  that  of  the  sulcus. 

The  soleus  J'ig.  ^04)  is  a  Hat,  verv  broad,  ami  rather  thick  muscle,  the  upper  portion  of 
which  is  covered  bv  Uu-  gastrocnemius,  the  lower  porticm  be  ing  situated  immediatelv  beneath  the 
deep  fascia  to  either  .ide  of  the  gastrocnemius  tendon.  The-  nu.scl..  arisen  Irom  the-  capitulum, 
,K.sterior  surface,  ami  outer  Ix-nler  of  the  fibula  fr.mi  the  poi-Hleal  line  .id  the  surface  immedi- 
atelv belcjw  it  upcm  the  posterior  surface-  of  the  tibia,  and  from  a  tendinous  arch  pasMng  over  the 
popliteal  vessels  between  the  tibia  and  fibula.  Hie  tendinous  ar,h  0]  the  sohus.  Shortly  after  Us 
I,ri.nn  the  muM  Ic-  become-,  broader,  and  e  dlibit^  upon  il>  ]  osterior  aspect  an  aponeurosis  which 
ismMinuousNvilhatcidon  ^^hich  fu>c-.  with  that  of  the  ga>tro.  nemius  and  also  receives  the 
inse.rtions  ,•  lower  Iving  lateral  mUM  ular  fa>ciculi.  Thi>  Ic-.tdon  of  the  triceps  .ura-,  broad  at  hrsl 
and  becoming  narr.mc  r  and  thic  ker  a.  it  pa»c-s  downward,  is  km.wn  as  the  uiUaneal  Inuhn  itnuh 
ArhiUh  .  it  i.  tin-  strongest  tendon  in  the  entire  Ix.dyand  is  in>erte.I  into  the  ui.per  margin 
of  the  tube  rosiiv  of  the  calcanc-us.  ,       .  .  11. 

The  triceps  Mine  also  in,  hides  ih,  plantaris  (iMg.  ;,04i,;i  small  muscle  wit  a  very  short  but 
rather  strong  b.  liv  and  a  verv  long  -lender  tendon.  It  aris,  s  fn,m  the-  external  enicondyle-  ol  tlie 
femur  to  the  inner  -ide  of  and  s.,mewhat  alH.ve  the-  outer  h,  ad  of  the  gastro.  m-mn,s,  «  hie  h  partlv 
covers' i!  :,nd  the-  short  muMuler  b.lK  i-  dim  tc-d  ol.li,|Uc-U  .mtw.rd  and  downward  betwc-en  the 
uastrcKnemiu.  and  sole  c,s.  Tlu  slen.le  r  tendon  lies  up.m  the-  inn.  r  si,le  of  the  soleus,  runs  d.mn 
ward  along  ihe  i.m,  r  margin  -f  the  tendo  Achillis,  and  fadc->  auas  partly  into  .his  structure  ami 
j)artlv  into  the  dceji   fasi  ia  of  the  leg. 

Tl„   ,n,,ps  -ur-  I.  s„p|.l.-l  '.y  .K-  „.  .  ,1  n,  ,.,  ,      I.  ,.r.    1...  •  ,.!.en,.,r  ll,  vi (  ilv-  f..,.,.     Th,..,.l,emaris  a.  .s  as  a 

(cllsnl-  i.f  llle-  letl'l"    \'  I'llll'. 

THE  POPLITEVIS. 

The-  popliieus    I-igs.  ^0  1  ,ind  ^o-.)  i>  a  Hat  triangular  musde  which  is  in  a  class  by  iisc-lf.     It 
i.  .iu.atce!  in  til,  s.,nu- lav.-r  as  the  soleus.  with  vvhieh  it  is  dire. Iv  related  by  its  U.nmt  ami  outer 


IniiiT  head  of  Gaslrocn 


InH'^i-  hriid  :}fpv^l-orneiin, 


Tendon 

of  ! 

semiten-  I 
diiwsus 


Crura'.fascia 
(deep  layer) 


/'.'iintarii  ■ 

lute.-  hi'd 
Ciisfroni 

A  ■citatr 


Pmmaeus  I 
peronacus  I 


(iilranea 
*  I       tfmiim 
^ii/i  ptron 
nlittflCllI 


rir  irt'> 


Fig.  3U3. 


fig   i(i4. 


p 


THE    MUSCLKS   OF   THK    IKC. 


221 


margin,  and  is  covered  by  the  gastrocnemius;  it  runs  immediately  over  the  iK.Men..r  .urta.e  of 
The  knee-joint.  It  arises  (inserts)  by  a  tendon  from  the  external  epieondyle  of  the  fenu.r  and  ron, 
the  arcuate  popliteal  ligament  and  inserts  (arises)  in  the  trian.uhr  area  alx.ve  the  poph.eal  hne 
upon  the  posterior  surface  of  the  tibia.  The  lower  portion  of  tlu.  muscle  .s  covere.l  by  a  la>aa, 
aponeurotic  in  character,  which  a'so  gi^c.  .H,in  to  muscular  tibers.  lU.neath  the  tendon  of  or„„. 
(insertion)  is  situated  the  poplil.ai  hnrsa  <.ee  pajje  ,3"'.  ^vhich  communicates  wUh  the  knee- 
joint. 

The  ..opHtous  U  .upplu-d  by  .hc  .it>i..  n^rvc.      I,  a.-.s  as  a  ..nsor  „f  .lu-  ar.i.ular  ,  ap...,-  of  .h.  W.H.-ioi,,.  an,l 
hdps  to  rotate  the  tibia  inward  (when  the  knee  i>  rleNedl 

THE  DEEP  LAYER. 

The  muscles  of  this  laver  (Fifi.  .^o?)  .the  ,.osition  of  which  has  been  previot.sly  described) 
have  experienced  a  peculiar'  displacement  with  reference  to  those  of  the  antenor  ^roup  smce  the 
S^  1"  o  erior  is  pushed  awa  uc.n  the  :ibia  and  situated  in  the  middle,  w  .le  the  .^.or  .  ., 
c!rum  lies  a.a.nst  the  tibia;  the  llexor  halhu  i>  conse.,uently  lies  upon  the  hbula  a,K  there.ore 
to  the  outer  and  not  to  the  inner  side  of  the  llexor  di.itorum.  as  nn^ht  Ik  expected.  The  correct 
relation  is  restored  bv  a  crossing  of  the  nn,>clcs.  that  of  the  tib.ahs  posterior  .k curr.n,  .n  the  Ic, 
,vhile  the  tendons  of 'the  .lexer  hailucis  and  of  the  flexor  di.itorum  do  not  cro..  unul  .h.y  reach 

'"'  te ^Llau/^^^terior  (Fi«s.  ,0.  and  ,.  .  i.  a  Ion.,  ,  ather  Hat,  di...  tlv  ,  c-nniform  mu.  Ic 
(llu.  lower  ,.,r,ion  is  onlv  semipenniform .,  which  arise,  l.a  short  -cndon  from  ,hc.  upp^T  1""'- 
>f  Ute  postlrior  surface  of  the  tibia,  from  the  interosseous  ntcn.b.ane.  and  .rom  the  --  scjr.acv 
of  the  ibula  beside  the  .lexer  diKiton.m,  which  frec.uentty  ,  ar.ly  cover.  U.  Imincc ha  el  b.low 
this  origin  a  verv  stron,  tendon  appears  in  the  mi.hlle  of  the  mu.cic  vc-r^n,  «radua  ly  .0  U.  nmc. 
rder,  and  parses  l.hind  the  internal  nudleolus  to  the  sole  of  .he  foot  I  he  .e.don  ,s  >n.e,te. 
dtie.lv  nto  tl  tulKrosity  of  the  navi.u.ir  bone  (Fi..  ,..).  son,e  fascuuh  be.n,  ouvctly  prol...^d 
to  thJ  internal  cuneiform  and  others  radia.in,  al>o  .0  the  remannn,  cuned  ,rm  l,ones  and  extend 

inc  as  far  as  the  (ul)oid.  ,        . 

M.ove  the  malleolus,  ,hc.  tibiali>  posterior  cros...  be.ea.h  tlic  Hexor  .l„Uoa.m,  .0  , ha,  U. 
tendcm  assumes  a  position  internal  U.  that  of  the  latter  ,.ascle.  Heltind  the  malleolus  U  .  ..ua-ed 
within  a  tendon-.healh  in  the  huini,llr  /(..,/mr;,/  l:ee  i)a-e  -\^il. 


Il  prochi' 


,  pl.un.n  11, AioM'of  I'l.-  fool  .m\  ,iUn 


,  I  he 


inn.r  iiiarj-ir,  oi  ihe  .v.le  i  .u|.M.,,iiMU- 

The  flexor  digitorum  longus  (Ki^s.  ,,0.;  a-^d  ,;m  r.sembk-  .he  tibialis  pn-t,.!,,,-  in  i.s 

external  appearance .     1.  i^  p.  uniform  above ,  scntipenniform  belou  ,  and  he.  a,  l,rM  „pon  ,he  nl,.a 

an  1     1  wer  .ourd,  of  the  U.,  be, ween  ,1k  tii,ialis  poMeri-v  and  d.c  .lexor  hallu.  ,>.  .he  .ormer 

n^       Kin,  crossed  bv  i,  a.  a  sh.h.ly  higher  level.     The  mu.  ic-  ari..  .rom  .h,   pe.Menc.r  M,rfae  .^ 

rimerosions  crest  of  the  tibia,  and  i..  .endon.like  ,ha,  ,-.  ,],.■  .ib.al.  p..„;nor.  .  deveiope^ 

,      .  .,   ,  >.^.,.,...  „f  ,1, ..h.      Thi.  tendon  is  sitnal.el  .0  ,lu    outer  sulc-  o.  .ha,  ol  ,he 

Eir^Ilr'and  ntns  lH.nea,h  ,he  lacinia.e  ii.a.nen.  ,o.he  s,.i,..,f  ,h    „.,  ,l,..  ..n,  when. 
,  ,,ivid  s  in.o  four  .ettdon.  for  ,he  outer  four  ten..      These  perfot.Ce  ,h..  tendo.s  o.  .!.■  ll.  xo. 


^m'- 


:^m'^j^^:^ 


^ 


in  si 


i 


J  i 


222 


ATLAS    AND   TEXTBOOK   OF   HUMAN   ANATOMY. 


Fig.  306.-The  muscles  of  the  anterior  surface  of  tl„  lower  leg  and  of  the  dorsum  of  the  foot.     The 

transverse  crural  ligament  has  been  removed. 
Pic  307. -The  muscles  of  the  lower  leg  and  of  the  dorsum  of  the  f<x)t,  seen  from  the  side. 


diRitorum  brevLs  and  pass  to  the  ungual  phalanges.     (Further  details  as  to  the  relations  of  the 
tendons  are  given  on  page  231.) 

The  muM  k-  is  suppli..!  by  the  tibial  nerve  and  flexes  the  second  to  the  fifth  toes   (especially  the   ungual  ,,l>alanges). 

The  flexor  hallucis  longus  (Figs.  30^  and  311)  resembles  the  other  two  muscles  in  -his  group, 
but  it  is  somewhat  shorter  and  stronger  and,  at  the  same  time,  distinctly  penniform.  It  is  the 
most  external  muscle  of  the  group  and  preserves  this  relatitm  throughout  the  leg.  It  arises  by  a 
short  tendon  from  the  posterior  surface  and  outer  border  of  the  fibula,  Ix^low  the  origin  of  the 
soleus  /  e  from  the  lower  two-thirds  of  the  Ijone,  extending  downward  to  just  above  the  malle- 
olus '  \  thick  tendon  which  is  situated  in  the  center  of  the  broad  muscle,  commences  m  the  middle 
of  the  leg  and  passes  through  the  outer  compartment  of  the  laciniate  ligament  to  the  sole  of  the 
foot  (Fig.  ,v  1 ),  where  it  crosses  the  tendon  of  the  Hexor  digitorum  and  runs  to  the  ungual  i)halanx 
of  the  great  toe  and  indirectly  also  to  the  other  toes. 

The  mu«  le  is  supplied  from  the  tibial  nerve.      It  flexes  ,he  great  toe  and  indirectly  also  the  four  lesser  to,.s. 

THE  MUSCLES  OF  THE  OUTER  SIDE  OF  THE  LEG.  THE  PERONJEL 

The  posterior  iH.rd.rs  of  Ix.th  of  these  muscles  are  in  relation  with  the  soleus  and  with  the  deep 
flexor  group,  while  their  anterior  margins  are  in  relation  with  the  muscles  of  the  extensor  group, 
from  which  thev  are  separale.l  in  the  lower  third  of  the  leg  by  the  lower  portion  of  the  shaft  of  the 
fibula  and  the  external  malleolus.     Tiny  are  situated  in  the  external  crtiral  region. 

The  peroneeus  longus  (Figs.  ;,ot.  an-i  307)  is  a  very  long,  distinctly  semipenmform  muscle, 
which  ariMs  l,v  indistinctiv  separated  anterior  and  posterior  heads.  The  anteri.-r  head  is  a  short 
tendon  from  the  head  of  the  fibula,  the  contiguous  portion  of  the  external  e.mdyle  of  the  tibia  and 
the  .rural  fascia;  the  p.slerior  springs  from  the  upper  two-thirds  of  the  outer  surface  and  outer 
border  of  the  fibula.  .\t  the  junction  of  the  middle  and  upper  thirds  of  the  leg,  In.th  heads 
pass  into  a  slightlv  llaltene.l  tendon  upon  ihe  anterior  surface  of  the  muscle,  which  broadens  as 
it  descends  and  passes  beneath  the  nthianil.i  prromorum  (Fig.  ;,07)  (see  page  230)  in  the  gr.H.ve 
behind  the  external  malleolus,  to  the  outer  sid.^  of  the  sole  of  the  fool.  Deep  down  in  the  sole 
the  'end.m  lie~  in  the  groove  of  the  culxml  (Figs.  ,^1  and  ,;i2),is  provided  with  a  thick  sesamoid 
cartilage  or  sesamoid  bone,  and  passes  L-  the  UiIh  rosity  of  the  metatarsal  bone  .^f  the  great  Icks 
s,,m..  filKTs  being  prc.l.mgc.ll..  the  internal  .•ut>eif..rm  and  to  the  base  of  Ihe  second  metatarsal  bone. 

The  peronanis  longus  almost  entirely  conceals  lite  origin  of  the  perona'us  brevis;  in  the  lower 

(.  ,,      .      .1,    I.,...  r  -eiv  he  --e"  i>oib  i"  fn..ii  of  and  behind  the  maruinsof  the  perona'US 

I. .'in  01   ine  le^  iile  LiiuT  mt\\    oi     ..t..   .,< .       . 

longus  or  iis  tendon. 

The  i-ronau.  longus  i.  M.ppli'-I  f-n,  ,he  peroneal  nerve.      I.  abdu,  .s  the  f,«„,  assi.,.  in  produ.  ing  plantar  flexion, 
and  ilevates  the  outer  margin  of  the  sole  (pronation). 


Tendon  of  biceps 


Tibia 
(Inner  surfnce) 


Pes  anserinus 


Tuberosity  of  tibia 


Plantaris 


Soieus 


F.xtensor  digitorum 

longtis 


Extensor  Crural  fascia 

hailuds  longus         (Deep  layer) 


Extensor  digitorum- 
brevis 


Cruciate  lig. 


I  xtensor 
Httllucis  brex'i-i 


Calcaneal 
tendon 


Tendon 


of  peronaeus  HI  \l\\^  \\1  \\\ 


Tendon  of  ext. 
hiiU.  long. 


^Patellar  lig. 

Capiiulitm  of  fibuin 
Tuberosity  of  libui 


Tendon  of  peronaeus  lent; 
\--^  Peronaeus  brevis 


Super  pfronaeal 
rrtinacttlum 

Inf.  peronaeal 
retinandum 
Tendon  of  peronaeus  long. 


Fig.  306. 


Tendon  of  peronaeus  brev.  jendon  of  peronaeus  III 
Fig.  307. 


^'~;^  ^-^i^^m^r  '^4^S^  ^ 


4--.;"l=S: 


1 


I    '  i:^ 


■■*»*r 

if 

t: 

W'^^^'^'   W^^^^'^WM^: ...  p.; 


THE   MUSCLES   OF    THE   l.EC. 


223 


1      .^■.■  ch„vi..r  ihin  the  lontnis,  which  il  markedly 

The  peron^us  brevis  (Fi^s.  ,oO,  ,08,  ^p\^^^Zn..^^uri...  an.l  anterior 

resembles,  and  by  whieh  U  >s  largely  eoneeak^^  ,'\;";.,r  margin  of  the  external  malleolus. 

,^.1..  of  the  lower  half  of  t  e  1;  ^  J  ^   ;:^:;;^     ^^^'the  muscle  and  then  passes  to  the 

The  tendon  commences  m  the  middle  of  the  upper  pc  .^^  ^^^^^^^  ^^^  ^1^^. 

:::=;v:r=rr^^;"----^^^^^^   --'> 

1„„K,,I  inlJ  tht  .k.rsa  ui«.r,™r.»is  of  llu'  l.uW  l-c.  

,-,. , „ ,.  »„.».,. ." -  —    ■'  ■"■'" '"' ' ■ '" 

dorsal  iVxinn  anil  pron.m.m. 

THE  ANTERIOR  GROUP.  THE  EXTENSORS. 

The  outer  margin  of  this  grcup  is  in  relation  with  the„er...e^  ^:''-:Z:::::;t 
isolated,  since  its  inner  margin  is  boun.led  by  the  .nner  sur.aee  of  the  t>b,a. 

group  are  situate.l  i,,  tl.e  -^J-'-  --;;  "-^f;;;^;  ^^  ,„„„  „„,,,,  ,,hi,h  is  broa.l  alx.ve  and  narrow 
The  tibiahs  anterior  il-gs.    ^^  -^        ;        .;^  f^,„,  „^,  .„,,,  ,,Hace  of  th.  libia  as  far 
below.     It  is  the  strongest  muscle  ot  tlu  gnap  anl  „,,.„,,,r,n.      The  upper  ihinl  of  the 

,p.vard  as  the  external  condyle  an.  from  the  "-;-  ^  ^  '^  ;  ;^,  ,,,,,,,  \l  „,,.„..  of  ihe 
nUle  is  marl<edly  adherent  to  the  deep  fasna  ol  ^'^  y^,  ;  '  "^^^^^^^.^  ^^^  ,  ,,,.end.  This 
,.,  a  develops  a  llat,  broad  tendon  whtch  ^--^^'^^    ,,:,..,„  ...he  foot,  and  upon 

-:;:;:  ..nnto  the  inner  border  of  t,,ei,a.  of  t...n.tmet.a^  _^^^^^^ 

i.ini-rnMr«innfth.-f....t(>.n!i"iatiun>. 

.-        1   .,,,1  U  1  riiluT  weak  -einipennilorni  muscle 
The  extensor  hallucis  longus  (l-gs.  ,06  and  _;;';';,  ^.^,^,,^^„^  j.^,,.,,,,    tIu.. 

K,.g  to  the  outer  .de  of  the  libiah,  ^-^^-^^^^^^^Z  ^^^^  -1,.  origin  of  the  ext.nsor 
two  muscles,  partaulariy  the  latter,  .-ncea  ^   ;  ' ^  ^  ^    ^^.,.,,^  ,„   ,,^.   ,■,,,„  ,,,    f,.,,.   th. 

hallucis,  which   is  from   th,    n,ner  surhu^o,   ,h.    ^       ^  ^,,^„.  ,^  .,H„i,,  .  undon 

„,j,,,,„  portion  of  tltc.  in,.ro.>eous  men,brane.      ^  ^ -^        '  ^  ,  ,.^..,,,,,  „,,,,,,, 

is  |ornu.<l  which  is  .tuat.d  ,n  dte  an.er.or  and  --        >      '  .....out  inward  and  passes 

r,b,rs  which  are  .lirected  obliquely  Irom  ahov.  dov^nwa  d  .m-l    r  ., 

itLh  the  <ruciau.  ligan.en,  ..  th.  d..rsal  .urface  o,  the  great  ,o.. 

Th  .  extensor  digttorum  , communis,  longus  .l.g..  ,.o(>  an<l  ;..)  i^  dte  -'--;;;;-!;;;; 

The  extensor  aigii"'"  ,„.  iv.lln.is    which    t  otlurw we  re-eml)les.      i  ni 

^,c  ^,,^.  .„,,,.„  ..nd.  is  ^ironger  than  tlie  extenso.    hallu, .  .  ^^^ 

;^;-,;  j„  „.  ,„>-  7'-- »-,;r;:r,:::;;.;;:i:»: -.h:^'-":  ,"•;;;., .,.. 


IM 


AII.AS      .Xn    TEXT  HOOl  OF    HVMAN    AN     ^^M^ 

Fig.  ^o8.— The  mu.-d.     uf  o  (lorsum  of  the  l 

T'herompanim-msoftluirmiuti-liK'amcm  liHv     U-vn  .ru-a  ami  th.' undon      ,ih.|,,:         i^'iisors . 
tjcfiirc  tlifir  in^tTtiuns, 

Fk..  309. — Th    ]vlant;>^  .'.(x!     :rosis. 
Fig.  310. -T!'      uperti<  ial  1       r  nf  tli.   pL.  Uarrri-,     les. 

The  plantar  (as(i.,  has  Iwri  largely  "        '."ifnmi  th(   -  r  ucoflh.   ll.-\   r  (iigiu.ru  i  brevi,. 


.iT  shortly 


brane.  The  u,.i.er  imnion  <..  :!;<■  musck  i-  adh.  rcn!  -)  tnc  origin  of  the  til)ialis  anu-nur  and 
to'the'duci)  fascia  of  the  leg.  1;k-  tenrlon  i-  situated  1  the  anterior  margin  of  the  muse!  and 
re.  lives  the  mi.ldie  and  inferior  liln:  vhich  pursi.  .,  rour,.  similar  to  those  of  the  extci.sor 
hallueis.  During  ii>  I'^'-'^'i?^''-'  '*"'"'t,'h  ■■  -niriai  ligament  <^  just  a  -n-c  it,  the  U  '  >n  sub- 
divides into  four  ilat,  rather  ^^.■ak  lendons,  uliuh      n  t.,  Uiv  lorsal  a   oncuroscs  of  1;      sec    i 

to  thi'  lll'lll  toes, 

■nu  perotiaeus     -rtius     Mgs.  306  and  ,31,    sLvms  to  h.    ,  part  01    'n' extensor  digiiori 
It    irises  Ip       'hose      xv  ne  lati'  '  muscle  wni.  h  come  p        the  In-.        portion  ..f  the     hue 

hs  !lat  tend.      runs  tjcneath  ih.    crucial     'iganuT-    uth  thus.         tl;  nsor  dig-orum  .    d 

inserted  hv      cans  of         it  tefiinous  ■  •.•  ansion      to  lite  dors  1  suiiai.  of  the  I         met 
bone. 


TI1. 

:he  fiHlt. 


_;iti)ruM!      len' 
-  are  s^^vilje. 


Mtrr  UK 
,    ijrae 


^lus  assist,  in  jiroii  -:-mt; 


.ft!-. 


Ur  'ik. 
\tensi 

Tl     ex 
■  lich  .    -•• 
isi     in 
.,[ 
1:,  :-sal   !,■ 

1,.  eat! 


THE  MUSCLE'      F  IHE  FOOT. 
THE  MUSCLE-    OF  THE  DO^'  M- 


hand,  the  di'"  -^.. 


lecl  of 


Kit  i.s  providei 


.  brevis  (Figs.  -  ;(>,  ;  s,  and  ^15  a  ■ 
uic  .iorsal  surface  ol  the  >nes,  joints,  nid  II 
the  exien.s<)r  digitonim  brexi-.  with  whii  h  it  is  au 


lat.  1  ascle 

;s  of  s.     It 

rent,  from  ilie  dorsal 


.»,  passes  forward  and  inwa'd,  and  in  tile  region  of  the  base  01  the  lirst 
ines  continuous  with  a  tlat  narrow  tendon  which  nn  ~  over  the  metatarsal 
ulon  of  the  extensor  longus,  the  two  tendons  togeth       forming  tiii'  d.irsal 


..'Xtensoi  digitorum  brevis  ( Figs.  ,;;o6,  ,;;o,^        !  ,:;i  .s)  ari.ses  togetl'  •  He  preceding 

,0111  the  dorsal  surfac  e  and  the  adjacent  p.^  1  of  the  lateral  surta.e  oi  ilie  calcaneus, 
livides  into  three  1  rarely  four)  muscular  bell.^  which  terminate  in  very  slender  tendons 
.  .  .u 1    Ov-'i    -"'I  fonrih  Iocs   apd  fusinc  with  the  tendons  of  the  extensor  digi- 

•.-;    tie,    -T^'-ifi,    .,fi)... .     --  .    -.1-   . 

longus  to  form  dorsal  ajioneuroses. 

Both  mt.s.le,  u,K,n  the  .lnr<uT,.  ul  the  i,>„t  are  futiplie-l  1.)   tlte  ,1.-1.  peroneal  nerve.     They  .xtoml  llie  toes,      .\ 
teni|..n  for  the  Intl.'  1ih'  is  r.irelv  pr.'sent. 


1^.  :rv 


^ 
IC 


I'.:  { 


^'U 


THE  MUSCLES   OF   THE   FOOT. 


225 


THE  MUSCLES  OF  THE  SOLE  OF  THE  FOOT. 

The  muscles  of  the  sole  dilTer  materially  from  those  of  the  palm,  since  in  addition  to  the 
frroups  for  the  ^nat  and  little  toes  there  is  also  a  central  muscular  mass.  This  central  group 
is  formed  by  the  flexor  digitorum  hrevis  and  the  fiuadratus  planta-,  an  accessory  hea.l  of  the 
flexor  digitorum  lonRUS  which  arises  in  the  f.x.t.  The  superficial  muscles  of  the  sole  are  cvere.l 
by  the  plantar  aiK)neurosis  (plantar  fascia)  (Fi.i?.  :,o<))  (see  page  233),  wuh  vvhuh  they  are  partly 
adherent. 

THE  MUSCLES  OF  THE  MIDDLE  OF  THE  SOLE  OF  THE  FOOT. 

The  flexor  digitorum  brevis  (Fig.  ;,io)  is  a  thick  elongated  muscle  entirely  covered  by 
the  plantar  fascia,  and  forms  the  middk  pUwtar  cmimm,'  (see  page  a;,;,!  (••"'K-  :^°<')-  '^  ""'^^■■^ 
by  a  short  tendon  from  the  inner  tulxnle  of  the  calcaneus  an.l  from  the  j.lanlar  fascia,  with 
which  the  entire  pro.ximal  half  of  the  muscle  is  adherent.  Just  in  front  of  the  mui.lle  of  the 
sole  it  sulxlivides  into  four  bellies,  terminating  in  four  flat  l.ndons,  whuh  beluive  m  exactly 
the  s;ime  manner  as  do  those-  of  the  flexor  digiton.m  >ublimis  in  the  hand,  /.  . .,  ihey  are  per- 
forated by  the  tend.ms  of  the  flexor  longus  in  the  region  of  the  i.roximal  phalange^  an.l  are 
inserted  chieflv  into  the  second  i)halanges. 

Tlie  posterior  jK.rlion  of  the  flexor  digitorum  brevis  is  in  immediate  relation  with  the  two 
alxluctors  (hallucisaml  digili  V)  which  form  the  middle  an,'  .xternal  plantar  eminen.es  (I'lg. 
.o.,^  and  the  origin  ..f  the  muscle  is  especially  adherent  t..  the  aUiu.  tor  halUicis.  Us  anterior 
portion  covers  the  tendons  of  the  flexor  .ligitonim  l.mgus  .,nd  the  lunibri,  ales  an.l  is  in  r.lation 
on  either  side  with  the  short  musdes  ..f  the  great  anrl  little  toes. 

Thf  musili-  i>  >upplir'l  I'v  llv  inti  rn.il  |.l.inl.ir  turvr. 

The  quadratus  plantse,  aUo  termed  the  jhxor  mssorius  an.l  th.'  <'iro  quadrala  Sylrii 
(Fig.  Vi).  niav  be  regar.le.l  as  a  plantar  hea.l  of  the  flex..r  .ligitorutn  l.Higus.  It  is  situated 
upon  the  ilorsal  surfa.e  of  the  flex..r  brevis  an.l  is  entir.ly  (.nere.l  by  tlu'  latter  muscle.  It 
takes  origin  bv  mean-  of  two  hea.ls,  ..f  wlii.h  th.  inner  is  usually  ill.'  stronger,  fr.im  the  plant.u 
surface  of  the  calcaneus  an.l  fr.im  the  l.mg  plantar  ligament,  an.l  the  flat  ami  approximately 
nuadran-'ular  muscle  inserts  int..  the  outer  margin  ..f  th..  t.n.L.n  ..f  tiu'  flexor  longus  .ligitorum 
•IS  it  passes  obli.|uelv  across  the  s,.le  of  •  f.n.t  fn.m  within  .mtvvai.l  an.l  In.m  Inhiml  forvv.n.l. 
Th.'  insertion  .Kcurs  l.fore  the  iVxor  ;us  ten.L.n  h.is  sulnlivi.!..!  int..  its  f..u,  .ligilal  shps 
■ind  after  it  has  .  rosse.i  th,-  ten.lon  ..f  llu  fleN..r  halhuis.  .\l  the  .rossing  ..f  these  t.n.L.ns  they 
assume  their  proper  positions  (see  page  22^)  an-l  are  always  ...nne.te.l  bv  anasionu.ti.  IiIkts. 
While  the  ten.i..n  of  the  flexor  hallu.is  runs  in  the  long  axis  of  the  t..e,  an.l  .  ..ns,  .pu  ntly  in  th. 
axis  „f  tra.tion,  those  of  th.'  flexor  digitorum  pursue  an  oblLpie  (ourse  as  alnne  .lescnln.!  an.l 
deviate  from  the  axis  of  tra(  tion  by  about  to  degrees. 


Till-  .|U.i(lr.itu-  pl.inl..-  i-  Mi|.|.li.  .1  l.v   tlir  iM..n..l  [.l.im.ir  mnr 
|,.Milun>  111  111.    Itixi.r  iiJKil..riiiii  !■    itfu-  ihi..  .1  -ii.iijjhi  ,.r.i   .imi  in;  ir.i-'-  1 


.; 1...  i.....l..n. 


«s 


226 


ATLAS    AND   TEXT-BOOK   OF    HUMAN    ANATOifV. 


Fir.    III.— The  miiicUe  la ver  of  plantar  musdcs. 

Th.-  flexor  .ligitorum  brcvis.  ,ho  ib.iuc.or  hallucis.  an.i  .'he  ab,lu.,.,r  digi.i  .,uinli  hav.  In-.-n  r.-,m.v.„;  the  ..-n.lon- 
shfath.^  of  the-  .limits  and  of  the  pi-ronxus  lon^us  have  Ihto  opetu-cl. 

Vu:    ji2.—T^e(leq)lav(Tcif  plantar  musrles. 
The  tendon,  of  the  flexor  .iiKm<.run,  lon«us.  the  llevor  hallu.  is  lon^us,  and  the  ..uadratu.  p)anta.  have  Ix-en  renu.ved. 


i  iici 


I  I 


THE  MUSCLES  OF  THE  BALL  OF  THE  GREAT  TOE. 

The  muscles  of  the  hall  of  the  groat  tcK'  (lilT.r  from  those  of  the  thenar  eminence  not  only 
in  their  numlxT  but  also  in  the  fact  that  one  of  them  arises  from  the  posterx.r  extrem.t)  ol  the 
calcaneus  an.l  the  other  two  from  the  anterior  portion  of  the  tarsus.  The  ball  of  the  great  toe 
eonse.,uentlv  contains  one  long  an.l  Uu,  .h.,rt  muscles,  ^vhile  all  four  muscles  of  the  thenar 
eminence  ai^c  practically  of  the  same  length,  on  account  of  the  shortness  of  the  carpus. 

The  abductor  hallucis  (Kig.  :,.o)  is  a  long,  triangular,  ,Hnniform  muscle  which  occupies 
the  entire  inner  margin  of  the  f.n.t  and  whose  origin  is  situate.l  imme.hately  alongside  of  that 
of  the  flexor  digitorum.  It  forms  th..  internal  ,.lantar  eminence  (Fig.  ,;o„)  and  arises  from 
the  inner  tutx-rcle  ..f  the  calcaneus  from  the  a.lja.ent  ,K,rti..n  ..f  the  inner  surfa.e  of  that  l..ne, 
from  the  laciniate  ligament,  an.l  also  from  the  plantar  a,Hmeur..sis.  which  ...vers  the  mus.le 
completelv  bv  the  ra.liations  ..f  its  mi.l.lle  p.rtion.  S.,on  after  its  ..rigin,  a  flat  strong  ten.lon 
.levelops  in  the  mi.ldle  of  the  muscle,  which  is  inserte.l  by  m.a.ts  .,f  the  int..mal  sesam.,..!  l.>ne 
into  the  first  phalanx  ..f  the  great  to.,  an.l  into  its  .lors.l  ap..neur.,M,.  The  .lex..r  hallucis  brev.s 
is  siiuate.1  Ntween  th..  ten.lon  ■  of  the  alKluclor  hallu.  i<  and  tl.xor  hallu.  i^  longus. 


The 


,  I,,  i,  .„|,,.l.ed  l,v  ihe  ,„..  rn.a  |.l,,n.,,r  n.  rx  ■  .      It^  ■  !>.,  1  fum  lion  i-  .he  ..l.du.  li,.,,  .,f  the  «rea.  toe.* 


The  flexor  hallucis  brevis  ,Figs.  ,;,,  an.'  .;>-m  is  mu.h  ~lto,„r  titan  th..  ab,luc:or.  t 
arisc-s  turttv  fn.m  the  plantar  surfa..-^  of  the  mi.i.lle  an.l  external  .  i.n..if..rm  iK-ne.  an.l  ,.art  y 
from  th..  ten.lin..us  pr..l..ngati..ns  of  the  l.,ng  ,.lantar  ligament  whi.  L  f..rm  .he  ~h  ath  ot  the 
.Krona.us  longus.  Like  the  lU.x..r  polii.i^  brevis,  llie  inser.i.m  of  the  -nus.le  .im,  es  into  lw., 
'lips.  lH.tween  which  PUS.SC-S  the  tend..n  ..f  the  flexor  hallu.  is  longus.  The  inner  shp,  t.-g-tur 
with  the  addu.tor  hallucis,  passes  int..  the  t.  tuL.n  of  the  internal  sesanu.i.l  b..n..:  th..  ..uter  shp, 
,„f;ether  with  the  a.l.lucf.r  hallucis,  passes  t..  the  evt.mal  sesanu.i.l  l^.n.'.  I  h.  ,.ut.  r  margin 
of  the  muscle  is  in  relation  with  ih..  alKlu.tor.  the  inner  with  th.   ...l.iu.lor  hallu.  iv 

The  „n..  le  .1.  xes  ,  l,e  ,u  M  U,   and  , .,1-'  l'.-'^  ''^  >'"    ^  '"■'  I''"""  """   ■""'  '"'"'^   '"  ''"   '"'"'•''  '''""  ■" 

ntrvr. 

The  adductor  hallucis  (Fig.  vj)  is  a  .lislinctK  bi.ii-ital  muscle  an.l  the  tu..  hea.ls  .lo 
no.  unit,  until  th.v  alm..M  rea.  h  th..  ins..r.ion.  Th..  .-W/./m  li,.ul  is  a  n.un.i,  strong,  elongate, 
mus.le  ariMng  fn.m  th,-  plantar  ^urfa..  ..f  the  .  xt.  mal  .  .m.iform  l..ne,  in  ...mmon  wuh  an.i 
partly  a.lh.  ren"  to  .he  t!.  x..r  hallu.  i..  fron,  th.   bas...  ..f  the  ■.r...n.l  an.l  thir.l  m...a;ars.-,i  iK.nes. 

.The    m.rked    .levelo,,M,e.,.    of    mo.,    -,(    the    ,m.M  1.  -    ..1    the    «na,    and    i.,ne   .,.v    o,    ,,.,!.    -i    ih.    iimmd 

r..„«e  o    notio     o.  ,h...  di«i,-  wiO he  .,M.,d  .overtnu.  ol  the  f,..    alt .he  .on.  tu.on  tha,  ,h,.,e  mu«l..,  n.. 

.T,:..     .     ...s.  ,„„  tha,  thev  ,dav  an  in.,..r,an.  o.te  in  ,u,.,H,r,in«  ....  ar,  h  o,  ,h..  f,...    ...,..,  .allvMn.e  the  a 

.,^„  V  ,i,..,  no.  .  ,..M th.  t.H  a.  all,  'm,  ..  .n-ert,  d  in, ■  pra.ti.allv  nnmovahle  l.fth  n,..,a,ar.al  !.«,.. 


fcii      ' 


I 


THE  MUSCLES   OF   THE   FOOT. 


227 


and  especially  from  the  anterior  extremity  of  the  long  plantar  liganiint  (see  ])agc  141).  The 
broad  muscular  belly  is  at  first  situated  in  the  middle  of  the  sole,  covering  the  i)lantar  interossei, 
and  it  then  passes  inward  toward  the  external  sesamoid  bone  of  the  great  toe,  and  in  this  situation 
unites  with  the  weaker  Iraitsvcrsc  licail.  This  arises  by  a  puriiy  niuM  ular  origin  from  the  jilantar 
aspect  of  the  tarsometatarsal  joints  of  the  second  to  the  liflh  toes;  it  remain>  muscular  until 
its  insertion,  while  the  obti(iue  head  usually  exhibits  an  aponeurosis  before  reaching  this  point. 
Both  heads  are  inserted  together  into  the  first  ])halanx  of  the  great  toe,  tile  tendon  of  insertion 
containing  the  external  sesamoid  t)one. 

Thi'  aililiHlcir  li.illuc  i^  i-  svi|)pliiil  liv  ilu'  cxtiTn.il  ulanlar  nerve.      lis  .  hi,  f  funnioii  i-.  ad.hu  ii..ii  uf  ilu-   fiUM  tin-. 
THE  MUSCLES  OF  THE  BALL  OF  THE  LITTLE  TOE. 

The  muscles  of  tin's  group  lorrespond  to  thoM-  of  tlie  hyiiollunar  eminence  botli  in  numb(r 
and  in  function,  but  the  alKluctor  is  mucii  longer  than  the  otlier  two  muscles. 

The  abductor  digiti  quinti  (Kig.  .^10)  nsembles  the  abductor  haiUuis  not  only  in  its  posi 
tion  but  in  many  other  respects.  It  forms  tiic  external  jilantar  eminence,  and  is  tiiic  k  and  broad 
t)ehind  and  narrow  tid  tendinous  in  front.  It  ari-es  by  a  >horl  tendon  from  the  outer  tulnTcle 
of  the  calcaneus  be  -nle  the  tlexor  digitorum  brexis,  and  also  (piite  extensively  from  llie  plantar 
ajH-neurosis,  which  covers  the  greater  jiorlion  of  the  muscle.  The  insertion  is  jiartly  into  the 
tui)erosilv  of  the  fifth  metatarsal  bone  and  partly  into  the  outer  liorder  of  tlu'  lirsl  phalanx  of 
the  little  toe.  The  inner  margin  of  the  al)du(  tor  digiti  \'  is  in  relation  with  the  Hexor  digitorum 
bre\is  behind  and  with  the  llexor  digiti  \'  b!c\i>  in  front. 

It  is  su|i]ilii'il  l>v  till-  cxtrmal  plMnl.ir  jutm-.      lis  ^jiei  i.il  fum  li.Mi  i>  .il)ilmiioti  >,i  iW  iillli-  (oc. 

The  flexor  digiti  quinti  brevis  (Figs.  ,^10  and  ,:;iii  is  a  --mall  elongated  iiiumK  which 
arises  chiellv  from  the  anlerior  portion  of  the  long  jitanlar  ligament  (see  page  i(i)  and  is 
inserted  bv  a  short  tendon  into  the  first  phalanx  of  tile  little  toe.  Il  is  in  relation  eMernally 
with  tile  third  jilantar  interosseous  musci  ■. 

The  opponens  digiti  quinti  (Fig.  u  1  >  is  smaller  but  somewhat  b--  ider  lii.in  tlu  tlexor 
bre\is,  the  two  muscles  lia\ing  a  tonnnon  origin.  It  inserts  into  tlu'  oult  r  liorder  of  the  anterior 
portion  of  the  fifth  metatarsal  bone,  extending  forward  almost  a.s  far  as  the  lu.id.  Ilie  musi  le 
is  almost  entirely  comtimI  by  the  abdm  lor  digiti  \'. 

THc  flivT  .iii'l  .i|i|»ininsainiti  \'  aiv  "iipi'lii'l  In  'ln'  '  Mirn.il  pl.inl.ir  n.rve.  Tlu  ir  .  Iiii  f  lunuiuns  ,iii-  iiiili.  .ilrH  I'V 
th,  ir  n.inii-si. 

THE  INTEROSSEI  PEDIS. 

There  are,  as  in  the  hand,  fov.r  dorsal  and  three  plantar  interossei  (Fi^s.  ;i.>  i<i  ^ijl; 
the  former  arise  by  two  heads,  the  lalter  by  one.  The  dilTerente  betwieii  the  hand  and  the 
f.Mit  consists  in  the  f;i<l  that  not  the  middle  but  the  seiimd  toe  receives  the  tendons  o|  iwo  ilorsa! 
/■/(/(•rovNc/  (the  first  and  the  seiond),  while  the  third  anil  ih.'  fourlh  pass  from  the  outer  side  into 
the  extensor  tendons  of  the  third  and  fourth  toes  (Fig.  .;i,<).  Ihe  inner  In  ad  ol  the  lirsi  dorsal 
interosseous  is  |HM)rly  deviloiHil;  il  arises  only  from  lb  base  of  the  first  milatarsil  Imiuc  and 
from  the  ligaments  of  the  tarsometatarsal  joint,  not  fro,"  the  sh.ift  of  the  Ikiuc. 


228  ATLAS    AND   TEXT-BOOK   OF   HUMAN   ANATOMY. 

The  planlar  intcrossei  (FIr.  314)  arc  stronger  than  the  dorsal.  They  arise  from  the  outer 
borders  of  the  three  outer  metatarsal  bones  and  pass  to  the  same  borders  of  the  correspondmg 
♦oes. 

Th.  in,..n,ss..i  .k.Us  arc  .upplW  by  the  ext.-rnal  plan.ar  none.  Thdr  (unctions  are  the  same  as  th.«e  of  the  palmar 
interoii,  with  certain  mo.lifualions  de.Kndent  upon  the  di.Terence  in  the.r  ,K«,t..,n  (see  page  .o,,). 

THE  LUMBRICALES. 

The  lumbricales  (Fig.  311)  "f  fn-  foot  arise  from  the  tendons  of  the  flexor  digitorumlongus; 
the  first  lumbricaUs  has  a  single  origin  from  the  inner  margin  of  the  first  tendon  an.l  the  other 


Fig.  ,?m 


f.i,..  (,»,!  iv..  , ,4. -DiaBtam  of  the  plantar  intcro.vsd. if  the  foot. 

Uranwf  dorsal  inttrossci  111  the  !'««.  ri'. .,)■•*■     "">b  i 


three  havf  a  bicipital  origin.  In  the  vicinity  of  the  metatarsophalangeal  joints,  they  pass  from 
11;;  inner  side  inio  the  dorsal  a,K,neun>ses  of  the  toes.  At  their  insert.ons  are  usually  s.tuate.l 
small  bursa-,  the //("i/ir/n;/ /ii/rw.  ,     ,     ,  ,„  1 

These  must  ks  are  supplied  in  a  variable  manner  partly  by  the  external  plantar  nerve  ami 
partly  by  the  irt.ernal  ,.laniar  nerve.  Their  functions  .re  similar  to  the  corresiKmdmg  muscles 
in  the  hatid  (see  page  203). 


THE  MUSCLES  OF   THE  FOOT. 


229 


THE  SYNOVIAL  SHEATHS  OF  THE  FOOT. 

Like  the  tendons  of  tb';  muscles  of  the  forearm,  the  muscles  of  the  leg  nm  in  synovial  sheaths 
as  they  pass  into  the  foot.  The  rctinacula  of  these  synovial  sheaths  are  formed  parth  by  rein- 
forcements of  the  deep  fascia  and  jjartly  by  processes  of  the  ligaments  of  the  fool. 

Upon  the  dorsum  of  the  foot  (Fig.  315)  arc  situated  three  synovial  sheaths:  one  for  the 
tibialis  anterior,  one  for  the  extensor  hallucis  longus,  and  a  common  one  for  the  tendons  of  the 

Extrnsor  dii^itorttm 
lonaiis  +  I'cronaus  III         lixlcnsor  hallucis  loiif^us 


Fibula 


m.  jirroturus 
brevis 


Tendon-shealh  0/  cxiriisor  dicilnrum  li'iif;us  and  l>rri>'i,rus  III 


Tninon  anil  Inidoii-shralh 
()j  fxlfiisiir  halliii'i^  Inni^us 

/       \  iti.  rxlnmnr  hallucis  brevis 


Superior 

prrinirat 

retinaculum 


Injcrior  fiiruncal  rctiiuu  iiluin 


I'rmlan  sheath  lendan  ,i>  fcro-        ":■  exi.iiynr  ,ii,i.       Tciidani  aj  cxieniar 

oj  In-ronaus  Tendon  and  n,i  us  I'l  1  Irrum  l.n.is'  dieitorum  lari^us 

lonKus  ■rndim'Shealh  oj 

'tfon.rus  hrevis 


Vic.  315.     'rtir  tinilnp. -Iiiatli^  ami  riliiiaiula  '^f  liiii.^uai  ami  cxliTiial  virfau-  ni  ilu'  Imii  (•;uini  "I:   1  diaKiammatiiJ. 


extensor  digitorum  longus  and  jieronanis  tirlius.  They  commence  in  the  U:'  ird  cn  c  .id  for 
ii  variable  'isliMKc  uiion  the  dorsum  of  llie  fool.  Their  retiii.uulum  i>  ihiellx  idriuiii  by  a  rein 
forcement  of  liie  dorsal  fascia  nf  the  fool,  llie  iritiiitlc  {untcriiir  aitmdiir)  lii^'iiiitiil,  wliii  h  arises 
from  the  outer  surface  of  ihi'  cdcaneus,  whcri  it  i.  adherent  to  the  intirosseous  talot alcaneal 
ligament,  and  di\ides  into  a  (ii>tal  and  a  proximal  band  wiiich  form  almost  a  right  angle  with 
each  other  (Fig.  ^of)).  The  proximal  band  runs  lo  the  internal  malleolus,  the  distal  to  1  u  dorsal 
surfaces  of  the  navicular  and  internal  (unciform  l)ones,  and  when  tiic  lallir  band  is  prolonged 


23° 


ATLAS    AND   TEXT-BOOK    OF    HUMAN    ANATOMY. 


to  the  external  malleolus,  as  sometimes  occurs,  the  ligament  jjresents  a  cruciform  appearance. 
The  outer  undivided  half  of  the  ligament  is  connected  at  its  origin  with  the  inferior  peroneal 
retinaculum  and  the  ligament  contains  three  compartments  separated  by  fibrous  partitions,  for 
the  three  synovial  sheatlis. 

At  the  outer  side  of  the  ankle-joint  the  two  jjcroneal  muscles  (longus  and  brevis)  have  a 
common  synovial  sheath  (Fig.  31 0,  the  upper  and  Umer  j.ortions  of  which  are  usually  sub- 
divided for  a  short  distance.  This  sheath  is  held  in  place  by  two  retinacula  which  are  frequently 
indistinctly  separated.     The  superior  peroneal  retinaculum   (Figs.  307  and  315)  passes  from 


Tendnti  shii}lh  ni  lihiiiUs  niitrriiv- 


I eiiddii-shriilli  ii/  rxlensur  hnlluin  hiiixiis 


-Temhni-shralh  oj 
tibialis  ftoilrrior 

'Tcndnn-shalh  n/ 
flfxor  ilii^ilontm 

Tt'iiilon-slw'itli     ' 
'  cxlfiisnr  hill,     .s 

loili^US 

'C'tlranC'il  tendon 
-  I.iii  iiiiiilr  lif;. 


'I'liui"!!  o;  ;lf.\"r  h.illtii  i 
lull:. 


I '  >td<<n-^ii'-!lii 
iij  ,'lixiir  di'^i- 


I  iiidi'nsliiftlli 
nj  tihiiilis 
tni\Iiri"r 


I  Ainiuttor  iidlliuts 

l-ltxiir  difiil.  hrrvis  X 


l-'Ii. 


•,!(,.  -Tlu  l,ml..ii-.lii-alh-  ;i  M  r.lin.n:!,!  of  llu'  inUrii.il  l...nl.i  ul  ihr  f.,.,t  ,,onir«h;il  .lusrammaliO. 


ihe  po^uriur  border  of  tiie  inuTnai  pnlKolu:,  to  \h,-  upper  extremity  of  tiie  tuberosity  of  the 
calcaneu>,  an.!  i>  alx)  conneiud  ■■•iih  the  ueej)  fascia  of  the  leg.  The  iiijmor  prroiuv!  rclnuifU- 
lum  iFig>.  307  ami  31.:;)  tMen<l>  from  tiie  outer  exinmity  of  the  i  ruciale  ligamenl  to  the  outer 
Mirfaie  of  the  <  aitaneu^  anil  its  iroi  iiltar  process. 

\.  .1,    ; _    ;,i,.  ..r  iK, I  1.   ;,,;.,!  1  J'i.r    ;iA>  ilu'fe  an-  three  synovial    heaths  for  the  tiliialis 

posterior,  liie  llexor  digilorum  longUN  and  liie  Uxor  h.illucis  longli>.  The  sheath  for  the  tibialis 
po>leriui-  i-  liie  shortest  and  exteniU  <'u\^  i-  tile  inner  border  of  the  fool.  The  two  remaining 
Nhealii-  are  K.nliiiued  into  tile  M,le  of  the  fool  and  extend  as  far  as  the  deeussatioii  of  the  ten.ions. 


Wk 


THE   FASCLE  OF   THE   LOW  ER   EXTREMITV . 


231 


These  sheaths  are  held  in  place  by  the  laciniak  linlrrnal  annular)  li^amnil  (Figs.  305  and  t,i6), 
a  wide,  ])o<)rly  defined  band  which  commences  at  the  internal  malleolus  and  jjasses  partly  to  the 
inner  and  upper  Iwrder  of  the  calcaneus  and  partly  to  the  plantar  surface  of  the  f(H)t  as  far  for- 
ward as  the  navicular  lx)ne.  It  contains  three  distinctly  sei)arated  comi)artments  for  the  three 
synovial  sheaths. 

In  the  sole  of  the  fiK)t,  in  addition  to  the  continuations  of  the  synovial  sheallis  of  the  llexor 
hallucis  longus  and  digitorum  longus,  there  i>  situated  the  sjjccial  synovial  sliealli  oj  llw  pinmiriis 
lonf^us,  which  surrounds  the  tendon  of  this  muscle  in  its  i)assage  ac  ross  the  sole  within  the  groove 
of  the  cuktid  (Figs.  ;,ii,  312,  and  316)  and  almost  to  the  point  of  its  insertion.*  This  >heath 
is  at  first  shuated  aljove  (dorsal  to)  the  tlexor  digitorum  brevis  and  the  tendon  of  the  longus, 
and  its  retinaculum  is  furnished  by  a  prolongation  of  some  of  the  fibers  of  the  long  iilanlar  liga- 
ment which  i)ass  Ix^yond  the  cutx)id  to  the  base  of  the  metatarsal  tH)nes  (see  page  141)- 

The  tlexor  tendons  of  the  toes  ;dso  jiossess  syno\ial  sheaths  which  reseinble  those  in  tile 
lingers,  although  they  are  corresi)on(ling!y  >iiorler  and  smaller.  The  longest  sheath  is  usually 
that  for  the  tendon  of  the  tlexor  pollii  is  longus.  The  retinacula  for  these  sheaths  are  the  Vdt^iiuil 
lifiamrnls,  which  are  analogous  to  the  similar  structures  in  the  lingers  (see  i)age  jo;). 

Within  the  >vnovial  sheaths  of  the  second  to  the  tilth  toes  exactly  the  s;inie  relation^  obtain 
which  we  have  previously  observed  in  the  lingirs.  since  tin  wiak  t(  ndons  of  the  llixor digitorum 
brevis  are  jierforated  by  the  much  stronger  tendons  of  the  tlexor  digitorum  longus  (>ee  page  J07I. 

THE  FASCIiE  OF  THE  LOWER  EXTREMITY, 

The  lower  I'Xtremily  is  envelojjed  in  a  very  strong  fasi  ia  (  Fig>.  317  to  3-'0'  Nvliith  i>  iuni>- 
ualiy  thick  in  certain  situations.  In  the  different  region-  ..f  ihe  extremitv  tiii>  la-i  ia  rc(en(s 
corresiionding  names,  and  wi-  conse(|uently  sjieak  of  the  iliac  fascia  the  fa^ia  lata,  the  crural 
fascia,  the  doi>al  fax  ia  of  the  tool,  and  the  plantar  aponeurosis. 

THE  ILIAC  FASCIA. 

The  iliiK  j,is(i,i  cov(  he  anterior  surface  of  the  ilioii.Mias  al)Ovi'  the  inguinal  ligament. 
.\l  the  inner  margin  of  th  ,.,.oa>  major  this  fax  ia  i-  ituitinuous  wiili  the  ju'lvic  I'aM-ia;  at  the 
outer  margin  it  iia>se-  into  the  thigh  with  the  iliojisoas  and  joins  the  jieitineal  ta-iia  to  torm 
the  iliopirthual  j,isn,i,  a  ])ortic)n  of  the  fascia  lata  (see  pagi'  -'3-'i.  In  doing  tlii>  llu  lax  la  i> 
attached  to  the  anterior  sujierior  sjiine  of  the  ilium,  to  the  inguinal  ligament,  and  to  the  iliopei 
tineal  eminence  (tin-  iliopcilhual  H;^<imciih  and  divides  the  .sjuue  beneath  the  inguinal  ligameiii 
into  two  compartment-,  an  outer  i()mi)artment  t'or  the  iliopsoa-  and  the  fi-moral  ner\e,  the  l<u  uiui 
miisnilornm,  and  an  inner  one  for  the  femoral  vessels,  the  hiniiui  vasoiniii.  Tlie  iiiai  la-oa  1- 
directlv  lonlinuou-  with  the  iran-versalis  fascia  (see  i)age  i()3).  The  lacuna  \a-orum  i-  rounded 
oil"  and  bounded  inlernallv  by  tile  lacunar  idimbernat'.-)  ligament  (see  j'age  Hqi,  and  lorm- 
tlie  internal  femoral  rim,'  '.-ee  pagi'  -'331- 

THE  FASaA  OF  THE  THIGH.  FASQA  LATA. 

The  jasrid  lata  (Fig-.  317  and  318)  (onsi-ts  of  two  layer-  whidi  are  separated  only  in  urtam 
situations,  and  its  difl'erent  ixirtion-  vary  greatly  in  thickne-.     It  i-  compo-ed  of  lonu'itudiiial 

*\Villiiii  Ihi-  Oil, 111)  111.   im.l.ir.  ..f  llir  piruiKiu-  |i>iitfiis  il.v.jnp,  .1  m -aiiiui.l  I".m.'  (.t  ,,umI,ii!i  1. 


''  if"' 


1 


vy 


232 


ATLAS    AND   TEXT-BOOK   OF   HITMAN    ANATOMY. 

Fig.  317.— The  fascia  of  the  thigh  seen  from  in  front. 

Fig.  318.— The  fa^iia  of  the  thigh  seen  from  behind. 

Fig,  3ig. — The  fa>iia  of  the  lower  leg  seen  from  liehind. 

Fig.  ^20. — The  fascia  of  the  lower  leg.  seen  from  in  fr.     '.  and  the  dorsal  fascia  of  the  foot. 


and  transverse  fasciculi  which  are  so  arranj^efl  that  sometimes  one  set  and  sometimes  the  other 
i)reponderates, or  both  mayoccur  together.  In  a  general  way  the  [losterior  jjortion  of  the  fa.scia 
lat.i  is  stronger  than  the  anterior  and  the  external  p<jrlion  is  decidedly  thicker  than  the  internal. 

U])On  the  jjosterior  surface  of  the  thigh  the  very  thin  sujxrtkial  layer  of  the  fascia  lata  covers 
the  gluta.'us  ma.ximus,  while  the  deep  layer  jjasses  beneath  th'.'  muscle,  and  over  that  portion 
of  the  gluta'us  medius  which  is  not  coxered  by  the  maximu,-.  the  fa.scia  assumes  a  markedly 
tendinous  or  ajioneurotic  character  and  is  termed  the  glulcul  jascia  (Figs.  2,:i8,  240,  and  241). 
Tn  the  glutvul  siiUits  fF'ig.  ,^iS),  o\er  liie  lower  ])ortion  of  the  glula'iis  m.iximus,  the  fa.scia  con- 
tains numerous  strong  transverse  fasciculi,  and  over  the  llexor  muscles  ii  i.-  of  average  thickness 
and  is  composed  ( hiellv  of  transverse  fasciculi  which  are  esi)ecially  will  marked  in  the  ])opliteal 
region,  where  tile  superlicial  layer  i>l  the  fa.scia  lata  covers  ui  the  jiofjliteal  spare  and  its  con- 
tents, the  dee])  layer  envelo])ing  iis  muscular  ntargins. 

The  strongest  portion  of  the  fa.scia  lata  is  situated  u].on  the  outer  -ide  of  the  thigh  and  is 
known  as  the  iliotibial  lor  Maissiat's)  htiud  (Figs.  jcjO  and  ,?iS).  This  Land  is  composed  cliielly 
of  strong  tendinous  longitudinal  fasciculi  and  receives  the  insertion  of  the  tcn-or  fascia'  lata'* 
and  of  a  portion  of  the  glula'us  maximus  (see  page  2ri).  lis  lower  extremity  i>  attached  to 
the  external  lubero.sity  of  the  tibia,  and  l)eneath  it  is  situated  the  va.stus  iaii  ;ali>  with  its  large 
ajioneurosis.  In  the  lower  portion  of  the  thiu'li  the  fascia  lata  givo  olT  a  .sejilum  u|K)n  lillier 
side,  and  these  ])ass  l)etween  the  fi'moral  muscles  to  the  lips  of  the  linea  aspera,  forming 
the  internal  and  cxlcrnal  inlcrmusculiir  .sepia.  Just  below  the  inguinal  ligament  the  fascia  lata 
i>  com])osed  of  two  layers.  The  supert'ic  ial  layer  ])a.s.ses  over  the  anterior  surface  of  the  sar- 
lorius  and  the  great  femoral  xcssels:  llie  posterior  goes  behind  the  sartoriii>  and  covers  in  the 
ilio])ectineal  fossii  (sec  ])age  2101  and  the  groove  between  the  vasiu-  nu-dialis  and  the  adductors. 
Over  the  adductor  muscle  the  fascia  i>  \iry  thin  and  transparent.  The  'ortion  of  it  mxering 
the  ]ieilineus  is  also  called  the  pcctimal  jastia:  it  tuiites  wiih  the  lower  extremity  of  ilic  iliac 
jasi'ia  to  form  the  iliopci lineal  jaseia  coxcring  ihi  l1(X)r  of  the  ilioi)ectineal  fossa. 

Immediately  l)elo\\  the  inguinal  ligament  the  .su|)erricial  layer  of  the  f.iscia  lata  exhibit>  a 
free  internal  margin,  the  jahijorm  marii^in  (Fig.  S'TK  which,  together  with  the  pectineal  fa.scia. 
bounds  a  round  or  o\al  depression  in  the  fascia  lata,  \hr  mal  jossa  (saphenous  opening).  Tin 
inferior  portion  of  tile  fall  iforni  margin,  which  i)asses  almost  imperceptibly  into  the  pectineal  fa.scia. 
is  called  the  injerior  eornii,  while  the  su])erior  portion,  extending  ujiward  <■•<  the  lacunar  ligament, 
is  termed  the  superior  eornn.  The  opening  of  the  o\al  foss;i  is  coxered  \<\  a  portion  of  the 
sutierticial  laver.  the  erihri ior^f!  ^astiii.  whicii  contaiti^  a  '.onsideral)le  (luan'.itx'  of  lat  and 
<|uile  a  number  of  foramina,  the  largest  of  whicii  gives  jjas.sage  to  the  ,i;n<t/  saphenous  vein  (the 
internal  saphenous  vein  1.     'I'hi-  x-ein  comes  from  the  foot  and  I  ';.  runs  upon  the  fascia  lata  and 

*  TW  ..urf.ii  c  of  th<'  li  n-iir  fu-i  i:i-  l.ini-  i^  iil-n  <  iimti'iI  !■     i  xrrv  lliiii  l.ivi-r  of  llii-  fasi  iii  l.ila. 


1 


t  lllt'Cill  ttl^flil 


falciform  rmi'X'n 


Suhi-utiiruou-' 


f etnonil  viin 


I'fi-tintid  JiUiia 


Suhaitaniou 
/'ii/iiitt'l/itr  bur>a       '  " 

I 


^/ihaitanfoii. 
rtitf/i'iir  t'lU'iii 


Cirrat  siifihcinniS 


Gluunl 
sii/ais 


i,iy<iiif  totnel 


I\^»i,tfiil  h>y^u 


Fig.  317. 


f-i<'.  lis. 


■f-         ! 


Iw  ■  wll  ~ 


^  ^.>:-:'^£--  m^^mm 


TmM^m 


f'ofUirrnl  fossa 


i'ti/iiinmf  tnuion 


m 


^ 


intrafftiu'llar  hnr-ii 


I  rtOf'Vi  I  ■>»■  mi  ml  /it;. 


(  riitiiiti-  li<<iiitiftif 


f'i,ir.  3t9. 


Oorsai  fastin 
of  foot 


KK-~.- 


L. 


r  I!: 


.filBf 


THE   RURS^   OF  THE   LOWER   EXTREXHTY. 


23^ 


empties  into  the  femoral  vein,  which  is  situated  in  the  region  of  the  oval  fossa.  The  oval  fossa  ( the 
saphenous  opening)  is  the  external  or  subcutaneous  femoral  rin}^  and  the  external  orifice  of  the 
femoral  canal.  (For  a  more  detailed  description  the  reader  is  referred  to  the  text  lKM)ks  and 
atla.ses  of  topographic  anatomy.) 

THE  FASCIA  OF  THE  LEG.  FASQA  CRURIS. 

The  jascia  cruris  (Figs.  311)  and  320)  envelops  the  muscles  of  the  leg,  hut  is  wanting 
iiver  the  inner  surface  of  the  tibia;  it  is  nickest  anteriorly  IkIow  the  knee,  where  it 
is  adherent  to  the  extensors,  the  perona-i,  and  the  tendons  of  the  pes  ans'Tinus.  It 
give-J  (>iT  the  anli-rior  iiihrmuscuhir  septum,  which  i)asses  Intween  the  extensors  and  tlic 
])eron;ei  to  tlie  anterior  l)()rder  of  the  libula,  and  the  posit  rior  inlrr»iiis<  nlar  sipliim, 
which  passes  in'tween  the  perona'i  and  the  flexors  to  the  jiosterior  l)<>rdir  of  the  fibula, 
and  itsui)|Kr  and  inner  portion  is  adiierent  to  the»pes  anserinus  (see  page  210)-  Upon  the 
posterior  aspect  vi  the  leg  it  divides  into  a  superficial  and  a  <leep  layer,  the  former  cover 
ing  the  triceps  sura  ,  the  latter  the  deep  group  of  flexors;  tUf  tricei)s  sura'  and  it^  tendon,  the 
tendo  .\chillis,ari  <()nse(|iiently  completely  invested  l)y  this  fascia.  In  addition  to  the  previously 
descril«(l  ntinatula  (see  page  2.^0)  the  fax  ia  cruris  is  especially  riinfon  cd  liy  the  Irnnsvrrsr 
(rural lii^timiiil,  which  is  loinposed  of  trasisverse  fao(  iculi  passing  from  the  tibia  t"  the  tiliula  uIhim 
the  ankle.  I;  is  situa.edto  the  proximal  side  of  the  cruiiale  ligament,  with  whidt  it  graduailv 
tjc'iomes  (onliniu>u>. 

THE  FASa^  OF  THE  FOOT. 
While  tile  d0rs.1l  fuM  ia  I  if  the  foot  ( I''ig.  ^jo  I  is  an  exceedingly  thin  iayer,  iIk  nl.iniar  apoiu  iiro-i- 
(Fig.  ;»))  is  the  thicke-i  iiortion  ol  the  entire  fasi  ia  of  llu'  leg.     In  the  middle  of  tile  ^oj,  ii  (on-i^ts 
of  a  Ncry  thick  a|KMieurolii   iaver,  (iimpo-id  cliiell\  n<  lungiludinal  I'a-cii  uli  with  -nnie  IiImt--  ■\hi(  h 
passobli(|Uelv  toward  the  Literal  margins  of  the  loot.  Tlu  proxiinai  portion  of  1  he, i|.nneuro--i>.i :,  •« 
from  tile  inner  and  outer  lubenles  of  tlu-  calca.neiis  an<i  i-  i  IomI>  aijlun  nl  lo  tin    Ioi.l;   mu-ilis 
of  the  fiKit  which  lake  their  origin-  from  the  same  Imnv   |oint^;    ii  i-  toi-ideraliK   iliiik^  r  ill. in 
the  broader  d'stal  port,,  n.      iiie  aponeun»i-  together  willi  llu    long  niu    It  ^  lorni^  die  inni' 
pUinl<ir  iinimuos  \inlir\uiL  iitidiih .  and  ryiiriuil:  M-ejiat-'eN  •.•>  lo  .-j;!.     It>  lap  r:d  p<ii-lioii^  .ne 
mutli  weaker  than  the  ic  ntral  jKirtion,  aii<l  I  lie  lliiikeM  |iarl  of  the  laui.d  porlioT,   i..  Minaled  over 
the  origin  of  the  alniuilor  digili  \'.     Numerous  slender  fa^iimli  pa--  f-om  'he  eiiiin    margin  01 
the  a|K)neuro-.i-  lo  the  ^kin,  and  low.ird  the  loe-  llie  aponeun>-i~  di  >  ule^  iiilo  four  ~lip~.  •  orre>-piinil 
ing  to  tile  four  outer  to< -,  wliiili  art   Ixniml  logethe'-  by  traiisvcrM   liUr-,  llu   /r./i/w.rw   j^i^iii.ili. 
I'lMin  thv  ttM~  the  .i|«iiieurovi-  gratluallv  ilisijipears  in  tin  ionmtii\e  tis>ue  la\ir^  of  llie  ^kin. 

llolli  lilt   f.i-t  i,i  I.Ua  .mil  lilt   laM  i.i  1  niri-,  like  llu   l,i-t  i,i  o|  iht   upper  i  xirt  iniiv ,  imm   p.i--ai;e 
|o  \ivmK  ,inil  nt  r\(^. 


THE  MOST  IMPORTANT  BURS^  OF  THE  LOWER  EXTREMITY. 

I.  Tlu   ui'ii  iili^iiiniiy  Inn  lidiitirii  hiir^ii.  iht   t  hit  t  Imrsi  upon  tlu   gii.il  Irot  li.inli  r. 
:.  The  Irm  hiiiilirt,   I'ur^'i  oj  llu   t^lui.iif  m,i\iiuii^  iset   page  jt-'.  Fig.  .'n^K 
i,.  Tlu    i;luli(>,   miir,it  hiirui   (set    |>.ig(    .•  1  J.  Fig.  .'>)><.  inioii-tant. 


II 


r 

234 

.\TLAS    .VXD    TF.XT  HOOK    OF    III  MAX    ANATOMY 

4- 

The 

sciatic  bursa  oj  the  j^lulcrus  mnvinius,  Ixtwicn  the-  tulxTositv 

of  the 

isehium  and  the 

Uluta-us 

maximus. 

tendo 

IS  of  the  glulieus 

5- 

The  (!«/'  rior  ( /roflnnilirii  !  hiirsd  oj  Ilu-  i^iuin us  imdius.  ljc'l\Men  tht 

nudiu.s 

incl 

na.\inni>. 

(). 

The 

■  pos/trior  {Irochautrrii  ]  bur  ii  n;  Ilu    i;/iiltiits  nudiiis,  bttwun  Uu 

leiuluns  of  ihe 

i;lulncus 

nuii 

us  and  ihc  jiiriformis  i.si'i'  |iagf  .^1.". 

-. 

The 

trociiant'rii  bursa  oj  llic  f^liila lis  niininim.  a!  Uu-  inM-rli<in  uf 

the  nnisdc  of  the  same                    | 

nanif  inid  ilu  ^Trai  Iroi  lianur. 

8. 

The 

pirijorm  bursa,  al  Uu-    iiisc-rlion  of  ilu    inuxk-  of  Uu-  >ani 

-   iiatn( 

-  iiilo  Uu-  <;r(-at 

Irochant 

(T. 

U- 

riu- 

i'ursa  oj  ihr  obturalorius  iiiUritus  (see  ])agi-  Ji.;,  l-'i^.    ioi  -. 

10. 

Tllr 

/);(;•'./  ('/  the  rictus  j,  moris.  al  Uu   origin  of  the  nui-i  1(   of  Uu 

same 

iianu-  from  Uu- 

margin  uf  ilu 

aei  lahuiiini. 

1 1. 

■Vhi- 

i/iopci  liiii  .it  bursa  oei-  pafzi-   2ii,l-'i^.    jijM   onasioiially  lonnnunii  aUs  wiili  Uu-                   | 

Iiipj'oint 

I.'. 

Tin- 

siibli  iiiUhoiis  iliac  bursa,  al  Uu    in.-erlion  of  ihr  iiiop.Mias  iiilo  Uu   li 

-s.-i  r  Iroi  liaiili  V. 

'.V 

The 

pectineal  bursa,  al  Uu   inst nion  of  the  iiiii^t  Ic  of  Uu-  same  n. 

me. 

14. 

Ilu 

^upirior  bicipital  bursa,  al  Uu-  oriL-in  of  ilu   loiii;  lu-ad  of  Uu 

)i(l-[).s. 

'v 

The 

injcrior  bicipital  bursa,  iK-iunn  Uu   u  inlon  of  ins(-rtioii  of  1 

u-  liin 

[IS  aiu!  ihi-  ioni; 

( Mirnal 

lalcral  lijianuiii  dl'hi-  ktui'  joint. 

If). 

The 

suhcutaiunus  prcpalillar  biir^a  i-vv  pa^i    1  \i>.  1m,!.;>.  ,u  7  aiul  ,, 

JO). 

17- 

Ilu- 

subjasiial  prcpalillar   bur\ii    isd-  |>af;i     i,;')i. 

iS. 

Ihe 

subtcmliiuaiy   pnpalillar  bur^a  t-n-  pa^i-    1  ;'o. 

• 


II).  'I'lu  su  prapatitlar  bursa  ii<    pagi-    i;;)  (omnumiiaii-  alnui^i   alw.iv^  wiili  liii    kiin 
joint. 

.•o.    Ilu  subiutatunwi  iiijrapatillar  bur^^a.  in  front  of  Uu-  upiur  '-Mrrmiiy  t.f  Uu-  li^anu  iiiiiin 

piilella      -^ri  |iaU(     1  i'l,  \\j~     :i,    and    ;.-c   . 

.?!.  'I  III  iticp  iii.rii pa/iil.ii  lair^ii  1 --i  i    |>am-   1;;  . 

->->.  Till  •■iibi  Hl.i'i-  I'us  l>nr  a  Of  Ihi  liilh  rosity  oj  tin  ///)/.;,  a -^lllH^il.ln(  oii>  biir^.i  omt  llii  tvdicnK- 
of  liu-  liliia. 

2;.    I  hi  sartorial  bur^a  (■-(-(    |iaui-   .m  |,  l-i::.   Jo8i. 

.'|.    Ilu  aii^irnii   bursa  i>n'  pat;r   :u).   \'\m.  ji).'^'. 

-■;.  Tlu  poplii,  at  bursa  i^.i  paui  ^  i;'iand  j.'ii  i  onimunii  air^  wiUi  Uu    kiui-  ioini. 

j').   Tlu-  iitlcnhil  i;a\lri>i  lit  iiiia!  buci  ' ->  1    pa^i-^  1  ;(i  and   j.?o,  l-'ii;.    ;o  ;  1  al-o  <  onnnunii  ,iii  s 
uiih  till    kni-i    joint. 

_•;.  Tlu  ^iiiiiiiinnlir.iiioiis  hur-a  1 -.  1   pau;<  -  i.;f)  and  :  {<)  )  nia\  lomniiiiikati-  \wih  tlu   kiui 
joint. 

.'S.    I'hi  ^iib<  Ulan- oil.    ,\t,riial    iihilhoiar    l<iif-a.    Mil«  utann.ii-    liiir-a  om  r    Uu     iMirnal 
malli-olu-. 

.'<).    rill  ^iilii  ulaihou.   inliriuil  iiialiiobtr  I'ur^a.   -\ilii  nlam  011-   Inir^.i   ovir  Uii     inUfnal   in.d- 
leoju-. 

io.  'Ilu  buisii  (i:  ill,    •rlH^  III  '/.  in  Uu-  mn-ro-Mouv  livMimnt  in  tlu   --iniiN  i.ir-i  iHtwi-in  the 


THE    m'RS.*:   OF     IHE    I.fAVER    ftXIKl.MITY. 


2.S5 


talocrural  and  talonavicular  articulations,  may  communicair  with  the  arti(ular  ca\iiy  f>f  ihc 
lalocalcani'ona\i(  ular  articulation. 

,^i.  The  siihlcnitiiioiis  hiirsa  oj  llir  lihiali  antirior,  at  ilu-  insertion  of  llic  liiidoii  nt  \\\v  tihiaiis 
antorior. 

7,2.  The  suhtcndinoiis  hursu  oj  Ilu  lihliill^  fxi.slinor,  at  the  insertion  uf  tlie  tenilon  nt  liie 
tibialis  |)osterior. 

_^?.    The  sulk  Ilia  nrous  lahnniiil  hiirsii.  a  -iihi  utaneoiis  bursa  l)inealh  the  lulxr  (  aieanei. 

.^4.  Tile  hitrsd  (ij  the  (lilt ii mill  lituloii.  at    the   insi-rtion   of  tile   tendo   Aeliiilis. 

^^5.  Tile  inlrniii liiliir.sof)luiliiii;;<nl  hiir\n-,  (orrispoiidini^  to  tile  inlernietaiar|)0|ilial:ni,i;eal 
bursa'. 

!,(>.  Tile  liniihrii al  hnr\ir  (see  Jiai^i'  jjSi. 

I  \~  in  1I1,'  1  ,i-',-  of  ill,-  ii|>|H  r  cvm-niily,  -o  em  in  ilu-  jow.r  a  1  l.i^^iii.  ,iii..n  cil  ilu  nui^i  li'^  of  1 ,1.  Ii  nf  llir  ^;IllU|l^  i. .  cm 
ni/f(l  alMivc  into  />.»^^</.v^//  a  fit!  pn  ii.\i<il  ^i-N  ,  .m  Im-  ni.t'ii  .  <  'v\in^,  iiowrsi  r,  t't  a  rnialioii  wlii.  li  tin-  lowt  r  limit  ut!.iir- 
KtK's  (turillj^  il^  <h  vi  Inpnunt.  .in  iint  r^i(in  of  iu  >url;t,  i  -,  a^  -  "Hiitar,  (I  with  lllo>r  i.f  ihr  ii|tiHr  limit.  ■»  <  ur>,  so  lli.il  ihr 
|><ist..i\ial  liiii'.i  I.-,  of  ih.  lliijih.  Iin,  .iii'l  looi  .,rr  ^im.ilitl  Mil  ilu  .ilih  rior  >nrl'a.  .■  ,iiiil  tlu-  |in-  a\i,il  niii>,  h  ,  mi  llir  |io  hiici 
surfatt.  turthcriiior.  ,  ilu  it  i^  not,  in  tlu  lit  r\t  |jIi  \il^i  -  <il  tlu  low-  r  linili.  that  tiiJinilr  ^r|i.ir.iliMn  of  ill-  tilu  r^  ol  ilu 
|iri'  a  vial  anil  |«t^l  a\i.il  mi|..i  li  ^  into  ili-liiu  1  .  onl  ,  -in  ll  .i~  .in  fomul  in  tlu  hr.u  hial  |ilr\ii~,  I  nit  tlu  |ii.  axial  ,iiul  |to>l 
axial  lilnr-.  ilu  iioi  1  oiii|ili  ir  ilu  11  v,|i.ir.iiion.  a  riiU  ,  iinlil  ilu  \  li.m-  n  .u  linl  ilic  low.  r  thin  I  of  thr  thi|.;h.  ilu  iliiivioii 
of  thr  ^riMI  s(  i.iiii   iutm'  into  tlu   liiii.il  an'l  |m  r.,iu-.il  ncr\r-  'H  i  urrini;  ,it  a  I  mill  thai  li-ii-l, 

Uf.irin^  tlu  M-  f.it  u  in  nainl.  .'  moriiliolniiii  .it  .  Liy^itu  .ition  of  tlu-  !nii..(  K-s  of  tlu   low.  r  linili  liia\  !..■  m.i.l.-  a .  follow  ^ 

I      I  111     Misn  I  s  01    1  HI    Ilii'. 
f'M   I'.i-t  axi.il  lulls,  h-s;    rfittifif^  ni'txiniit^.    -/»/..f(^  mriijtt^.  i^/tit-'ifi  miiii'itity,  an. I  /.  'm-t  ;.i\n,i  I'l,'.! 
(/'I   Vu-  .ivi.it  iiui.i  lis;    ilt'itit\,  l*iri;^irmi\     ''liirtilor  twtiriuty,  tt'>,iir<it<ir  ii!!<rtut\,  i^rtth/i!.  .in. I  iiii<iJr<ilit\  ;tin<ti\. 

1 1.  'I'ln     M  I  -.  1  I  -  1.1     nil     Int.  II 
(■M    p.  1^1  axi.ii  nni^.  1.  -:    ^■trwriin.  iflui-lrii ri>^  ;,  iiuin^,  an. I  ''/-  'f>    ;<  nuiri\  1  -li. .rl.  r  la  I'i  i.* 

\h)  I'n  i\ial  liiiK,  l,-^'  fut  ttiii'li\.  i;riliii!\,  ilildluh'r  lni:.'li\.  ihljtnfiir  lirf,'i\,  iiii<ittih-r  niili'Hli\,  ./././.'i. /..r  a;,'!?,',»«\, 
srmiiftfHthr'iih'^iiy.  ■■*  nntriiiiiihi^ii^    alul  hiitp'-  ;<}tuiri\  (  ioiii*  lif.i.|>. 

Ill      I  ill     Ml  s,  1  I  , 1,1,.. 

f.Jl    t'.i^t    i\i..l    mils.  1.  s       f\!ti!\tti    lin^iltflini    /*ilt,"/n.    fnr^nhi  rhm.    t\;itt\nr    ihilhiii\    l<tir^u\.    fll'i-ih^    >li:'iriitr^ 

pfroih' Wi  ti'fltiii^.  alul  fhr'>n,tn\  hni  /. 

I'm  I*rr  a\i.li  iini^.r.s,  (;,n/r..f  ».»i;/o,  f'iiiitifi^,  yn/,iix.  I'ttflH-t  ii\,  ;h\i*r  iln^ittitttni  /a.n;/(\.  Ithu>!i\  tit\iir:.ir^  jfrvitr 
Ihiltiiii-  /iiiii,'»\,  an.l  ./H.i./i.i/;(>  f'l iiih,  t 

1\      till     Ml  ..  I  I  .  .ii     I  111     I'.  1111. 
(.O    I'iKt  axi.il   iihuiIi-n;    rv/fHTfir  iliiiilnrum  hmiy  an.l  tilininr  h>l'itt>i\  /irr/« 

CI  I'r,  -.ivi.il  imiM  li  ■>:  //i vr  ilii^iinrum  hn  ,  /•.  ,i><Jii,  1  ir  Ii.iUmi  i\,  ,/>  !.•>•  hr,:  i\  li,iltu,  (..  ./W.i.  !.ir  ih^ih  i/iiinli  .i^r>.> 
»,  iM  ttt\:itt  tfti:>tri,  tuniUrifiit^.  iitUiui  ti'r  It  tit  lit  /.,  ;U  v.t  htt-i;^  lii^iti  >juitlti .  .in.  I  i>itiri''^i  1.      I  1>  ) 

*  Tlu    l.i.  .  p-.  f.  !n..Ms  I.  .lilv    I.  ). lis.  Ill     1  Ao  iniiM  h  ^  Willi iniiiou  iiivt  rl  1.  .n  .   it  ■  lontj  lu  .i.|  i     a  |'l»   ;.  vi.il  n  ih.  It 

an.l  it"  -h.trt  li.  i.|  It.  Im^s  |iriiii,i,il\  l.t  ih.  KJutt  .il  ^.1  ..I  inii^  1.  - 

t  "I  lu  .|ii.i.li.iiu  |.l  iiil.i  .  .illlutiiuh  ^ilii.ilt.l  in  Ihr  f....t.  i.  lita.  rtluli.a  iii.ir).h..|..m.  .ilh  ..n.  ..fllu  mu-.  1.  -  ..I  Ilu  I,  tf, 
Itiiiin  .1  .!•  lii.ilivi  ..f  Ilu  ■,imi  nui-(  1.   in  i-s  w  In.  li  «im  ■,  n  ,  i.,  ih,  il.  x.tr  I.hiuik  li.illu.  i.  ..n.l  ili.  iiln  ih.  |t.  tO.  n.  ,r 


J 


■1  ,v*; 

^1 


^H.  I  J"  V  IHil^* 


INDEX 


Abdomina:,  fascix,  i6^ 
musclfs,  157 
anuriiir,  157 

ilcvflopnicm.  164 
dcvi'liipnicnl,  1^)4 
flat,  157 

(ii-\('loi)mtnt,  164 
jH»sttTi(tr,  i6j 

(U'vclopmont,  104 
straight,  idi 

ilfvrli)|mn'nt,  164 
|M)rtiiin  of  |iritoralis  major  musdi', 

167 
ril)s,  128 

rinn.  fxtfrnal,  ijS 
AUluctor   iligiti   iiuinli    musric,    220, 
227 
function  'if,  200,  227 
nt-rvo  supply  of,  200,  227 
lirivis  must  If,  18(1.  210 
hallutis  mustle,  2 to,  226 
fum  lien  iif,  22^1 
ncrvi'  siipplv  uf,  22fi 
|K)iiicis  hrcvis  niu-itli-,  iSfi,  ig<> 
function  of    :,ji) 
iicrvr  iiipt^' .  of,  oii| 
longus  nniwii',  185,  11)7 
funition  of.  107 
inTvc  sup!»ly  of,  1^7 
At  I  (■s,w>rv  I'Kaiinnl-,,  io>i 
of  foot.  I  (0 
plantar  liganiml.  1  v; 
pr'Mfss.  28 
sril.tr  liiiann-nt''.  1  27 
At  ti.iiiul.ir  fo>-.i.  t>6 

noli  li,  o'l 
At  ctahuhini,  oi.  •*'» 
ticvclojinn  lit ,  o't 
Aironii.il  I'viniiiiiy  of  ilaviilc,  81; 
AcroniiiK  la\ii  ular  ,irti<  ul.ilion,  1  .mi 

liRanifnt.  120 
.\i  roiiiioii  prtHc— ..  8  I 
,\iMuctor  liri-vi^  imi-^i  It*,  ?o^^  2iti,  217 
funition  of.  217 
niT'.f  ■■•upply  of.  217 
canal,  217 

hallu<i«  imiM  Ic.  ji.i,  .'^'i 
fuiKiioii  of.  227 
ncr\c  "^uppK  of.  227 
lont!u-,  ifiiM  Ic.  jcx).  2i'i 
function  of.  Ji'. 
nerve  >uppU-  ol,  2il> 
niaijTv.i'i  niu^t  Ir.  20<),  ji'».  217 
funition  of.  217 
ncrM-  >upplv  of,   "1  7 
tnininiU'  nuisi  It-    .hmj.  .'.<>.  217 


Ad'luctor   minimu.s   must  Ic,    tunctitm 
of,  217 
nt'rv<*  t\ipply  t)f.  21 7 
muscles  of  tliivifi.  2iti 
tipeiiing,  tentlinous.  2  1  7 
jKiIlit  is  must  le.  iSfi.  it>t) 
function  of.  200 
nerve  suppl)'  of^  200 
.Vlitus  orliila'.  7  ( 
.VIminiculum  line.e  alli.e,  165 
.\l.i'  of  ethmtiiil.  fij 
of  ilium,  t)^,  1)4 

Nurfat  t's  t)f,  ()4,  tj5 
vomer:'.,  ;\(t,  65 
.Mar  ftiKIs  of  knee,  i^j 
liKaiuerts,  1 15 

IKiriion  tif  na^^ilis  must  le,  182 
processes.  6; 
AUt'oIar  Ijonler  of  mandible,  71 
(anais.  '17 
foramina.  (17 
)"«•'.  7> 

ptirtit.n  of  iiKinilililf,  7  , 
pron-ss,  ^7 

of  suj>erior  maxilhir\-.  6fi.  fiS 
.Mveoli  ft)r  teetli,  68,  71 
Amphiartlirtisis,  108 
Anatoniit  al  net  1:  o(  humerus.  .S5 
.Vnaitiiiu  .  tieliiiition.  r  7 
tlesi  riptide,  tit  rmition,  i  7 
Kcneriil,  ili  liniiioii,  17 
sjM't  i.it,  tlt-tinitittn,  17 
system. (lit ,  tlermition.  t  7 
If>lK>i;rapliit .  tletinition.  17 
Ant. mills  l.iitr.ili,  mus,  le.  i,)o 
It, nulls  must  le.  I  St, 
nietlitilis  must  If,  ii|0 
niu-(le.  i'^>.  hio 
fum  lion  of,  ii)o 
ner\e  sujiply  of,  mo 
qUiirtus  musile,  it)o 
funition  'if.  I  10 
iiervf  ^uppK  tif,  ii>o 
AnKioloyy.  tl'-linition.  17 
Vimle.  I Mcrnal.  of  si.tpul.i.  84 
inferior,  of  st  .ipul.i,  8) 
infrasternal.  <; 
intern. il.  of  s,  .ipui.i.  H4 
m.isioi, I.   n 

of   l.ollis.     t } 

of  parietal  iHine.  fionl.il.  S') 

masioiil,  ^i| 

i«iipit.il,  So 

sphenoidal.  ?i( 
of  rilis.  i.- 
of  St  apulii,  e\lirii.d.  8  t 


ipi.itlralus  l.diii  su- 
i.So 


.Angle  nf  sra[i'.ila,  inferior,  85 
internal,  8( 
su|)erior,  85,  84 
of  sternuni,  ^4 
parietal,  50 
puhic,  lit 
sphenoidal,  36 
suh.ostal,  ?5 
\ngul,ir  heail  tif 
perioris  n^ust  le, 
.Xn^ulus  iierni,  ^4 
.\nkle-ioiiit,  1^7 

ligaments  o'    1  V) 
.\nnular  li^imenl,  122 
toiierior,  127.  2.11) 
internal,  2?i 
of  palm,  205 
Imsierior,  20V  208 
Aiinulus  tvnipanit  us,  ^8 
\nserine  liursa,  2  nj 
\niagoni-l  mustles.  1  j  \ 
\nterior  alKloniinal  must  les,  157 
tie\elt)pniem,   1(14 
annular  ligament,  127,  221) 
arih  of  atlas,  25 
of  verlelir.i,  22 
articular  f.it  ei  of  talia-ieus,  10 

<-    t;ilH'>.  10 
atlanto'ii  t  ipii.il  tne' 
U'lly  of  tligaslrit     , 
iti|iitular  lii^.imenl, 
ilinoid  priHt'ss,  41, 
itintlyloiil  t  anal,  40,   .  ^ 
(oronoiti  protest  of  ni.nalilile.  7.' 
(osioirans\,rse   ligamcm,    iH) 
1  rani.il  ftfs.i.  (i 
crest  of  liliitl.i.  i.-si 
irui  i.il  tig.imi  ni.  i  ^  t 
irtis  of  stilit  ui.inttiii^  inguin.il  ring, 

1  so 
elhmoitl.il  f.ir.iniin,  Oi.  7> 
f'lnlaneitf.  Si 
gluteal  line,  f|| 
inferior  spine  of  ilium,  ij) 
intt  rt  oniKloitl  fo».i,  tut 
inliTniust  ultir  septum.  2  t  i 
intt'riH  I  ipittit  ,-\  ni  hontlrosis,  47 
inlertr.iiisvt  rs.iriii-^  mii^t  le.  15s 
inlraot  1  ipilal  svnt  liomlrti^is,  ,>(i 
t.H  hr\'mal  1  re>t.  '17 
l.iver  of  lumUnl.iiv.il  f,i-,t  ia.  150 
ligament  of  eMerii.il  m.tlleoliis,   I  57 
lonifitiitlin.il    liiijiaint    of    \ertel)t.il 

1  ttUinm,  1 1 1 
musi  les  t>(  leg.    •.'  t 
nares,  66,  76 


.hrane 
■'Uisi  le 
,  ,(i 
10 


238 


INDEX. 


Anterior  nasal  spini-,  j;,  68 
obturator  nu'iribrant',  115 

tulnri  li',  05 
pi'lvif  surface,  t)U 
pillar  of . subcutaneous  int^uinal  rin^, 

'5') 
portion     of    ■luiilraliis     Uiniboruni 

niusi  le,  I  (15 
:.aeral  foramina.  :!.S 
.sai  HM  oei  ypeal  ligament,  11  i 
saeroiliae  ligament,  i  jj) 
superior  spine  of  ilium,  04 
surface  of  su|)eri()r  maxillary,  <)(> 
of  thi^h,  muscles  of,  ^[4 
of  ulna,  S7 
taloialcaneal  articulation,   i  ^.S 

li^ami-nt,  140 
talot'ibular  lii^anu-nt,  1  ;o 
talotibial  lin.jnienl,  i  ;'i 
troihanterie  bursa   of  ^'utjcus   me- 
(lius,  ^54 
AnlenKxteriial    surface  of    humerus, 

S(, 
Anteroipternal    .surface   of    humerus, 

Sft 
Anlibrailii.ll  fasc  ia,  ;oy 
■Anlrum  of  ir.;hniore,  (iD 

tympanic.  5.,.  5H 
Aortit     optiiifm   of    tli.ijihrai^m.     i(f>. 

itil. 
.\|KTtura  piriformi-,    ;;.  (>^.  (<(<.   -(> 
.-\}M.'rturt    of  at|ua'(iuuas  vestiliuli,  e\- 
lern.il.  51; 
of  peKi>,  inferior.  1  ;i 

-upcrior.  I  (.~ 
ofi\nipanic    i.m.iiii  ulu-.    -upcrior, 

\pe\  of   tiblil.l,    101 

'if  p.itella.  'Ill 

if  pvr.tmiil  "f  timjH)r.ii  b..nt.  -: ; 
\|iii.il  inlonliiirl  lin.imenl.  1  1 ; 
\i«meurosis,  14^ 

palmar,  I'j.S.  J07,  ioS 
\|niph\ses.  :!o 

\pjieiulie  111;!!    >kileliin.  -•-» 
\t|u:iiluciu^  iiMhiea/.  iiriliie  .if.   ^f> 

vestibuli.  api  rturi  of.  cxp  rn.ii.  ^ ; 
\rih.  losi.il.  j) 

lunili«>ii»^l.il.  i\ti  Mi.il,  1(1^ 
intern'!.  ,0; 

of  llallir,  lbs 

of  v.li  u    ,    .'."O 

of  \ertebra'.  -'.',  .' ; 

ligaru  nls  betueen,  1 1 ,' 
pubi<  .  I  ti 
>u|R'fi  ilian  .  (lij 
lemllnoiis,  I  i  < 
/\(.jomatif .   t."^,    io.  40 
.\ri  11. lie  eminent  e    5 1 
Mltan.ent.  1  -•>* 

iMirnal,  1  io    iii^ 

ini'rn.'i.  I'l^ 
line.  1)1; 

|<iplili  .il  liKnini  lit.  1  ;:; 
\rni.  l«i  les  <if.  .^^ 
uptK-r,  fitensof     tnf.o  e  ..!,  inu-- t- - 
of,  i!o 

tU'Xor  ■  urfat  t    of.  nnisi  i,  s  of ,   is. 


]   .\ini,  upper,  mu.--,  les  of,  1S5,  i.S.*! 
i  lassification,  201) 
.\rlery,  vertebral,  .15 

canal  for,  .;(> 
Vrthrixlia,  1 10 
Articular  capsules,  lo.S 
of  hip-joint,  i%2 
of  phalanges  of  foot,  137 
of  hanil,  127 
cartilages,  ji,  108 
circumference  of  radius,  .S8 

of  ulna,  88 
crest  of  .sacrum,  21) 
discs,  108,  1  i.S 

of  elbows,  I  1  ^ 
emineiue,  of  (»ci  ipital  Ume,  40 
c*f  tenitioral  Uiiie,  5^ 
j        margins.  108,  ich) 
i        proit-sses,  20 

of  sacrum,  superior    Jo 
().'  vertebra-,  :  \ 
surfaces  of  calcaneus.   103 
of  patella.  t>ij 
of  rac|iu.>,  carpal.  .So 
1  of  tibia,  inferior,  100 

su|>erior,  c)t) 
\rticulari-  genu  muscle,  .'15 

subc  rureus  niuscle.  J15 
Vnii  Illations,  107.  loS 
.11  ••onie M  1.1  vii  ut.ir.  1  2C 
iinkle.  1  >7 

■111. into, iviil.  1 1 !    i  I  ^ 
.iti.into.  pi^iropliii ,  1 1  i 
allantoo,  1  ipiial,  1  1  ;.  1  :', 
ball-.ind  -01  ket,  1  \o 
biaxi.il.  I  10 
iiiioc  ul.ir,  loS 
■  .lit  .ineoi  nboicl.  I  .^7    I  ;.*< 
c  .irpometac  .irp.i'       ■   ■  : 

1  .'s 

of  lluiiiib,  l.'4.  1  .s 
(  hoparts,  1  (8 
t  01  hit  <ir.  to*) 
t  tiniiioun.l,  loc^ 
t  ondeioid.  1 10 
lostoti  m^versi 
t  oval.  I  51 
t  line oiiav it  ul.i! 
digit. il.  138,  1  ; 
c-tlip-oiili  '.  1  to 
gliding.  1 10 

ll'ilgi-,    lO) 

hip.  I  (I 

humeroradial,  122 
hunit  rouln.ir.  t .'-» 
intiTi  .11  pal,  I .'  1 
interihoniir.il,  1 1; 
int*  rmt  i.ii.ir-.d.  i  17.  i  m 

il.Ielph.iUtUft  :i:,    1  .i.-^.    I  ^-.    1  \'l 

intiTl.irsil,  I  57 
intrrviTti  bral.  :  i  1 
I.i.fraiii  ■>.  I  (I) 
iiicta..iriieipn.d.ingeal.  \ jy 

of  t'lumb.  I J7 
n\ii.'ia>    i,.li.ilangi  ,1!    1  57.  i  to 
III  .I'liaK.tliis,  1  (7 
of  at  lav,  ir  ( 
of  axi-.,  1 1  ( 


I  I'l 


I  ;7.  1  C* 
1  i<> 


Articulations  of  carpu.s,  124 

of  costal  cartilages,  117 

of  elbow,  I2J 

of  fibula,  136 

of  fingers,  127 

of  first   and   seconl   cervical   verte- 
bra', 1 13 

of  fcHit,  I.!7 

of  hand,  I2\ 

of  hea'l,  117 

of  knee,  T  51 

of  pelvic  girdle,  128 

of  jihalanges  of  fcKit,  137 
of  h.ind,  1^7 

of  pi>iftirm  JHine,  124,  1 -s 

of  ribs  with  sternum,  iiO.  117 
with  vertebral  colunen,  2<t,  116, 

'■■ 
of  .sacrum,  1 13 
of  shoulder,  I .!  1 
of  sternum  with  ribs,  iid,  117 
of  talus,  I  57 
t)f  tibia,  I  5(1 
of  toe-,  i;,7 

of  upjier  extremitv.  im 
of  vertebral  1  olumn,  1 10 


with  ribs,  2(1,   I  I 

(), 

>>7 

of  uri>t.  1-'  i 

pelvic,  Ij8 

pivot,  IOC) 

|>olya\ial.  i  to 

radioi  arpal,  i  2  t 

Milioulnar.  .li,-M!,  12 

i 

proxiin.il.  1.2 

v.ie  roili  ic,  1  .'.S 

s.idc!le,  1  10 

simple,  ici; 

-.plieroid,  1 10 

iiir.il.  IOC) 

-tfPviclinii  ular.  1  ic) 

-.le  nioc  cista!,  1 1  7 

t.el  "  .ileuneal,  1  57    1 

(S 

t.ilot  atcaneonavic  ular, 

,17.  '  •i'< 

lalcjrrural.  157 

t.Uim.i'. icular,  i,(S 

lar^l,   1  .■;,  1  58 

t.irwMni".  .i.irv.d    1  57 

1 

t<l 

lemijoinmandii  iilir. 

1 

•S 

libiolilieii  ir.  150 

trinsv"  ?  .1 ,  of  t.irsus. 

1, 

■-< 

trochoi'i    lOQ 

iriie,  '08 

uniaxial,  mi 

with  iongiiiidmal 

IX 

S,    IC'I 

with  tran-\-r-4'  axis. 

IW) 

uniliH  ukir,  !    ,% 

\-traeabis.  loj.     See- 

iK 

:  Titlw- 

Atlantci.i\!.il  .irti.  ul.iti' 

it- 

t  1  5,    11; 

\llantiK-\ii-in.phit   arti 

1,1 

ttiolis,   1  1  5 

,\tl,inlo<K  1  ipit.il  .irlii  ui 

ition,  1 1,1,  1 11; 

memliranr,  1 1  i 

anieiior,  1 15 

jKi-iO-rior.  1 15 

Alia-,  .M.  'i; 

.irtic  ul.i"  .11-  of.  1  i  I 

develop  '11  til  of.    51 

1  ■nil  maicsc's  of,  2^ 

iran-verso  li){ainen'. 

.f. 

II  I 

nmm 


INDEX. 


-'39 


Attoilt-ns  auriruI.T  muscle,  i-,() 
Attraiu-ns  auricula?  musLlc,  179 
Auditory  canal,  internal,  55 

foramen,  internal,  55 

meatii.^,  external,  3S,  40 
internal,  4;^ 
Auricular  surface  of  ilium,  cj^ 

of  sai  rum,  20 
Auricularis  anterior  mu.-n  le,   i  7S, 

muscle,  1  7.S 

funtticpns  of,  1  7*) 
nerve  supply  of,  \~(} 

(Misterior  muscle,  17S,  171) 

superior  must  !e,  i  7S,  17.) 
Axial  skeleton,  22 
Axillary  Umler  of  s<ai.u!.i,  S; 

faM  ia.  207 

fossa,  147 

margin  of  stajiula.  S^ 
Axis,  ijt,  2=; 

artii  ulations  of,  i  1  ^ 

(lens  of,  25 

ile\clnpnient  f)f,  ' 

iHlontoid  priHcs'^  nf,  j^ 


HA'-K.  fas,  \r  of.  156 
nnistles  of,  i  ^4 

(!»'Ve!npnicni  rjf,   1  ;h 
Hat.  I  1^ 

'Ifvili'pnieiil,  I  ;fi 
lonu.  140 

tlevelnpnn  III,   i  ^f» 
•>hiirt,  1^4 

•  ie\(lopment.  i'.i> 
It.tll  of  ^jrcal  I«K',  mu-mIi-^  i  i,  .-.'O 

of  liiile  lot-,  nin^<  le>  of.  .-^7 
li.ill-an'l-'^fH  kci  joint.  '  10 
hasal  li^aminl-s.  dor-al,  i.'7.  i|i 
itit' ro>*rou  ;.  I  -'7 
n-,1  tatat-ai,  141 
planta-    141 
vohii.  I, '7 
Ha-^i  of  maniiililf,  71 
of  nietaiarpai  Umh  •-.  fi! 
of  .net  iitrsal  't  )n(  -,  ic> 
of  p.itil!.'.  00 
of  ph.il.inirr- .  of  lirit:(  r-.  'j.' 

of  i-H  ^.  10^ 
of  Mapul...  S^ 
Ha^ilar  portion  of  o»iipii.il   l-o'n-. 

\> 
Ila-ripliarvngi.it  .  .ui.d,  4;» 
Ha•^l•^  I  r.inii  i  Mirn.i,    i,i) 
H.-llv  ol  -MiMlr.   .1: 
lii.irtii  ui.ir  nuiM  Ic.  r  jj 
Itiaxial  if'int^.  1  10 
lU.  <  p-.  Kra-hii  mn-.  !r,  iS^.  jSS 
funi  (i.tn  of.  iK) 
Mt  r\e  ■  nppiv  of,  iNf 
Ii-ntlon  of  lonK  111  .m!  ot,  i .  r 
frmoris  Ui\\>t  le.  20*).  21S 
full)  tioti  of    2  |S 
rurxc  siippU  of,  .'  iS 
Hit  li.il''*  fitt  nia^^.  \Xj.  iSt 
|iu  ipilai  It'irsa,  infitiof    _■  <  j 
-utHrior.  .•;! 
f;roovr,  rvTrrnal.  'S"^    .'-17 


Bicipital  groove,  internal,  iS.S,  207 
of  humerus,  85 

ridges,  86 
Kiciimoradial  bursa,  iSg 
Hifur<ate  liijament,  140 
Hilocular  joints,  loS 
Hipenniform  muscles,  142 
Hipinnate  must  les,  142 
Jlivenler  itrviiis  nius(  le.  152 

niandiluil.e  niuscie,  174 

muscle.  142 
R!iHxlve^.->i  Is  of  Ikhu-,  21 
Hone-cartilage,  20 
Hone-marrow,  21 
Hones,  m 

l»l^lod\t>•^^  K  i»f,  2  r 

Kruid,  K) 

calt  inetl.  20 

f  oni(«isiiitm  ot,  20 

dtvclopmnu  of,  .-r 

flat.  U) 

hl-iuls  of,    JO 

iiioruam'i  npn^iiiiK-n'--  of.  20 

irrij;ular,  20 

ionp,  K).     >^ce  aU()  Lorn^  I'onts-. 

macerated,  20 

nu-ni!)ranous,  21 ,  22 

Till  k  of.  20 

IUT%  C-.  Ill,    2 1 

lunririi!  t  arials  of.  20 
orjf.init   t  on^titiitnt>  of,  _>o 
jrieaniatii,  10 

ii.---tii-  of,  20 
tulMil.tr.  i»> 
xi^rral,   22 
Hony  loikini;  mi  4  h.tnisni-,  icS,  io<) 

|>|-1VK,    Hi, 

ti--i]e.  ."o 
Itra.  Iii.d  TiMi,!.  2-7 
Hrai  hi.di>  miumIc.  1S5,  iSij 

funi  tion  of.  I  s., 

nerve  -uppiv  of.   i.Si, 
Brai  hioradiali- nui-(  If,  iS;;,  k,) 

tutu  tion  of,  Kj; 

nerv«'    injOy  'il,  m^ 
Hrant  hioriHTK   nui~t  h  •-.   i>(.   1^; 
Hrra>t  iM.ne.    2-',   ^.\.     Sy\    also  .V/ci-- 

rft  tt 

11  road  Uoni  -.  ]<) 

liuii  al  f.tl  nia^N.  1S2.  iJ<\ 

Hill  1  ifiatiir  i  revj,  7  ^ 

Hm-  t  ophar\nneal  I\i~.  i.i.  i.S  | 
Muitiii^  \i-iia-  iuv'ulati>  vuprrior    ;m 
lUir'-.r.  ari^rrinr,  .■  10.  2  i  i 

I'i.  ipit.d.  infi  rior.  2;  j 

Mi|.rrior.  .'u 
lii  ipitor.-idiit,   t^i) 

'.il',int\d.  -u'h  ulaneou^.  2^1; 

-■■i.uohi.i.hial.  208 

■  tiliila!  ml<rov-*t-tr  >i,  208 

diitital.  ilor-al  ->ul'«  ut.meou-.  20S 

e.i-lriu  ru  ndal.inh-rnal.  1  ^0,  :jxi,  2\  | 

ututf*iftteor[d,  2r  2.  .* ;  { 

liiopi-i  tiiical.  I  n.  2U 

infrap.M-  ll.ir,  dn-p    i  ;■; 

>ul"  uliricou    .    I  ;'i     2  !  i 


Burs;c,  infraspinatus,  308 

inlerniv.i    irpoj  luilanReal,  200 

intermet  ilarsophalangeal.  2^5 

intralendinous  olecranal,  208 

latis>irmis.   140 

!und)rical,  22!^ 

malleolar.     >u1k  utane<)us     external, 

internal,  2  ^4 
nietacarpo|)lialani;eal,    dtirs.il     -,.{,- 

I  utaneou-'.  20S 
mm  ous,  14^ 
of  »  alcane.d  tendon,  2_;5 
iif  iMiriMir  t  arj.i  radialis  bnvi-;,  20S 
of  llexoriarpi  radialis.  2c<) 

uin.iris    20S 
<if  glula-us  maxitnu^,  Mi.itic,  2\\ 

tPK  hanteri)  ,  21  2.  2,^5 
medius,  anleric}r  Irtu  h.in  erii ,  2  ^  \ 

IMoii-rior.  21  2 

trochanteric,  212.  2  ?( 
minimus.  tnM  h.mtrrii  ,  2(| 
of  !ati----imu'  dorsi,  1  4'i 
I  if  lo\MT  (■\tremil\ .  2  !,  \ 
of  oliitiralor  internus,  21  ; 
of  olituratorius  intcrnu-,  21^,  2\\ 
of  rci  tus  feniori^,  2  ^  ( 
of  M-miincnibrano-^us  nui-'*  le,  210 
of  '-inus  tarsi.  2^  j 
of  lere>  major.  20S 
of  tibialis     ant»-rior        >ilil<ndin«ius, 

po--i(  rifT  -ulitrndinou-',  2^; 
of  tulHTo^ity  of  liii.i,   -idu  ulani-ou-. 

of  lippcT  e\trcmil\ ,  208 
iilcirana',  2ot> 
|tr(  tltn.d     y;i 
piriform.  2\  i 

Itoplilcal.    I  ;;<.    2^0,   22]  .   _  ;  • 
prepatellar,  -.ijb  iit.rirou-,  1  ,0,    2U 

-ul.faMJ.d.  1^0 
iditiiidinoiis.  I  ;f» 
sartorial.  :i  \.  2^\ 
St  iatit  .  of  i;iula'u>  ;ii.i\inuis,  .'  ^i 
si-niinu  inliranou-'.  1  .;''.  210.    •,» 
'-uUh  romi.d.  20S 
suIk  utaneta'-^  (  pit  orith  !,ir,  208 

otrn..n.d.   2^-8 

NlllKlflto'rl,     iSO,     T  S 

-uhs*  apular.   121,   iSS 
■^iditmdinous  iiiai    .  ;4 

olfit.in.d,  20S 
'  I'pnipatellar.  1  ;;    .•  ^4 
-yn  >\ial.  i.)S 

(  otJUJiunii  it  aiy    108 
tP»  li.intrrit  ,  2  \  : 

anterior,  of  glulau--  midiu->,   2U 

of  |^U:',tMi     ndnii-iii       -  ;  ( 
maxiirui'.  .'  r  •    2  , , 

|>»tsfirior,  uf  liluiani-  niei.'ti-..  212. 
'U 

^ul1l  utaneous.  2  \  { 


('  vi»  \\(  \i    Imr^a.  -uIm  ulanrou-, 
trndon-.  22.' 
Inir-a  of,  .>  j^ 


240 

Caliancocuboi'".  articulation,  i,?7,  i^S 
ligament,    -it 
l-lantar,  I4r 
Ca:'  -m-ofi'  ular  ligament,  140 
Caicunconaviiular  liganu-nl,  141 
dorsal,  140 
plantar,  141 
C'akani-otibial  ligament,  i3<) 
Calcaneus,  103,  10^ 

articular  surfaces  of,  10 j 
Ixxly  of,  10; 
<levelo)mienl,  106 
facets  of,  103 
j^riMiVO  of,  10,^ 
surfaces  of,  10^ 
CaU  muscles,  ji<» 
Calvaria,  inner  a<|ie(  t  of,  44 
Canal,  aililuclor,  317 
alveolar,  67 
auiliti>rv,  imirn.il.  S!; 
basi|)har>nReal,  40 
lurotitl,  5>.  5'^ 

extern, il  oriliu-  of,  40 
conilyloi'l.  4°-  4s 
anterior.  40.  45 
IMislerior.  40 
ilenlal,  inferior,  7J 
faiial,  50,  57 

m'ni<  nluni  of.  ^7 
for  verteliral  artery,  j'> 

\ein.  2(1 
Hunter's,  :;[7 
hy|ionlos-al.  to.  45 
infraorhit.il,  ''7 

en'r.iiu  I     'f.  7^ 
inKuin.il,  ISO 
tn;.n<lit>ulai .  7-' 
muMuloluliar.  ;;.  ^H 
nas..l.  7s 

nasi, 1. 11  lirym.ii.  04,  (■-.  ;, 
nutrient,  of  .1;  :\    .s; 
Mf  l»)ne-..  .-.. 
of  radiu-.  .s>.> 
i,f  temiKiral  1  -'ne.  ;7 
|i,il.itnu-,  ^(> 
I'h  irvpiie.i!,   to.  t;  i 
ii.er\  i^oid.  50,  ;>^ 
]iier>  ^upalatint .  si.  ''-.} 
sairal.  -M) 
>|)inii.   ;i 
verteltral.    '.  1 
vidian.  - 
<  ,.ii  ilii  uli,  '  .iriitiiiilcmiMnii.  ;  ■- 
C.oi.iliiulu-  ihnrda-  tMii|'..ni.  57 
,..,  hle.e.  ..rliM  i.f.  s'> 
mastoid.  s>t 
tympani" ,  ?>! 
Cinidis  vertelirali-,  )i 
('.mine  foss.i    'lO 
v'anir.us  nuisi  It .  i'"*! 
Capitular  li^i.iineni.  .ititerior,  i  ;'' 
(iiMeiior.  !  i<' 
tiansverse.  ot  f'mt.   I  \i 
ol  li.oi.l.  i-'7 
Capituluin  "'  liiii"'  ni^,  So 

i.f  ulna.  ,VS 
('.apsides,  .irtit  lll.ir.  !  os 
of  hip  ioini,   1 1;; 


INDEX. 

Capsules,  articular,   of  ph,ilanges  of 
foot,  137 
of  hand,  127 
Caro  i|uadrata  Sylvii  muscle,  325 
Caroticotympanic  canaliculi,  5''.  5** 
Carotid  canal,  55.  58 

external  oritice  of,  40 
foramen,  external,  $h 

internal,  55 
fossa.  172,  174 
groove,  41,  48 
tulHTcle,  3(> 
("arpal  articular  surface  of  radius,  81) 
hones.  8:.  .^v) 

anil  ulations  of,  i  J4 
central,  iji 
development,  o> 
supernumerary,  ij 
surf.ices  of,  00,  01 
eminenc  e,  radi.il,  go 

ulnar,  go 
<^r(K)Ve.  ()0 
ligaments,  I3fi 
dorsal,  303,  20H 

extensor    tendon    slieaths    Ih'- 
neath.  20\ 
radiati',  137 
tr.insverse,  127.  J05 
volar.  20.S 
CariMmiet  iiarpal    artii  ulation,    tom- 
mon.  i>|,  Us 
of  ilumdi.  1J4.  i-'S 
litjament.  dorsal.  i.'7 
viil.ir    I. '7 


of,   ,.M 


108 


Carpus.  80 

a.liculalion 

liganunls  nf 
Cartila«(s.  .'i 

artii  ular.  ji 

Imne,  20 

,o-tal.   ,.? 

I'rnlations  -if, 

iiilei.iriii  ular.  108 

^t  111  oiiia"-,  i,?t 
I, im  lions  nf.  1  ;' 
Cavities,  gl.noid.  ."it. 

na.al    7;. 

iiral,  •.11.'   of.  7^ 

oriiital.  ;  i 

pt  Imi  .  I  t:? 
(Ml;.,  eti-.tni.iil.il.  i'\. 

frontal,  ''! 

lachryni.d.  '■ 

in:istoid.  s  i 

iii.,\ill.i!  .    '1 

palatini     '  ;, 

sphenoid. i 
Ceni,  rs  •■! 


'M 


'S 


(I- 


Cent,  li 


.-,i|,. 
lal  li. 


01 


.1  ilia|"iragm,  I'l).  10^ 


tendon 
Cerebral  Ljga.   i 

of  -iihenoid    imnr.   '0 

siirfati  .  of  f-tjii.ai  li-'iu 
of  orhiia'  iw.i!es,  (■ 
.if  p.iriet:;    fume,  sn 
of  s|,heni.id  ti'ine.  4.' 

of  ti  mpiii  d  Uille.   ^.' 

(.'er\ii  ,il  f.i  .1  i.i,  I  77 


Cervical  muscles,  prevertebral,  i  -() 
ribs,  35 

vAlehra',    2.V     See    also    ]'erlel>rcr, 
cervical. 
Ccrvicalis  asccmlcns  muscle,  141) 
t?hassaignac's  tubercle,  2I1 
Check  ligaments.  loS 
Chiasma  of  tendons,  207 
Choana-,  30    "(> 
Chopart's  joint,  I,v8 
Chorda  dorsalis,  1 10,  1 15 

tvmpani,  S7 
Clavicle,  83,  85 
iMxly  of,  85 
development.  85 
e.xtremities  of,  8^ 
Clavicular  notches,  ;^^ 

jionion  of  pectoralis  major   mu.scle, 
i(>7 
Clinold  pro.  ess,  anterior,  41,  40 
middle,  48 
jKisterior,  48 
Clivus,  4,'v  4S.   |8 
Coccygeal  (ornua,  ,10 
Cmcyx,  30 

development  of,  ,^1 
joints  of,  1 1,; 
movements  of,  1 1? 
(■(Hhlear  ioint.  io<) 
Colla'-  bone.  85.     See  also  Clavicle. 
Cilles'  ligament,  150 
Common  i  arpometacarpal    joint,  12|, 

'-S 

UM-atvis  i)f  nosi',  77 
Ciimnuiniiaiing  synovia'  bursa-,  108 
Complexus  minor  muscle.  151 

nuisi  le,  I  s2 
Compound  joinf^.  loi) 
Compressor  n.iriuni.  182 
Coniha  nasalis  inferior,  (14.  f)7,  77 
Com  ha'  nasales,  77 

nii'dia.  '>! 

superior.  <^\ 

sphenoidale  .,    (8 

Conihal  crest.  (17,  61) 
Conduction  I'gaments,  108 
Condyle^.  20 
femoral.  1(8.  1  ;i 
of  (M  I  ipil.d  Imtie.  4s 
if  tibia    fvtern.d.  oo 
inn  rnai    ij*i 
I    Conilyioi  I  •  .inal.  to.  ,5 
[  .interim,   f-i.  t< 

I  p..-l<r'or.  40 

I  fuss  1 .  4  s 

,        joint,  I    o 
)        jMirtioris  of 
proi  es.,'^.  200 
of  m.mdibU.  -1 ,  7  ; 

pi,  icrio;.  7J 
of  skull.   ',8 
''omii  I  liga' leni,  1  >n 
Coral  0.11  romi.il  lii'amen'.  1 
Cor.iiiibrai  lii.il  burs.i,  <r.'-^ 
C.irai  obraihi.ilis  rue.  ie,  : - 
film  lion  of.  i'"', 
iier\ e  ,.up',ilv  ot.  I  s.; 
Cor.iuHlavii  ul.ir  lasiij,  17: 


I  Ipil.d  b,ine.  4< 


is^i 


INDEX. 


24 1 


CoracoclaWcular  ligament,  120 
Coracohuincral  liganiont,  121 
C'oraroid  proross  (if  scapula,  84 

lulxTfJsity,  S^ 
Cornua  <»f  fascia  l:ita,  232 
of  hyoid  htmc,  grouter,  7^^ 
ksscr,  73 
Ommal  suture,  36,  ^7,  7*) 
C'oronoid  fossa,  S6 

[)r(Mess  (if  cranium,  ^S,  72 
of  mandihle,  71,  73 
of  ulna,  87 
CnrniKiitor  '-u|)ercilii  muscle.  170 
Costa',  32.     Set-  also  Rihs. 
Costal  arch,  33 
cartilages,  33 

articulations  of,  1 17 
gr(K)ve,  32 

jKirtion  of  (lia|ihraRni,  164 
process,  24 

surface  of  scapula,  S3 
tulwrcle,  ligament  of,  116 
luhrrosily  (if  t  l.ivide,  S^ 
Co-^tfK  lavic  ular  ligament,  iif) 
CosliKoracoid  membrane,  170 
Costotransverse  articulations,  116 
foramen,  1 1  7 
ligament,  anV'ri.ir,  116 
middle,  t  16 
(K)sterior,  i  lO 
superior,  i  lO 
Cotvl*iiii  liganunt.  131 

note  h,  i)(t 
Coxal  tM>ne,  93 

development.  <)6 
ioint,  131 
Cranial  iMtne^,  44.  45 
fossa*,  41-43 
anterior,   p 
middle,   t  > 
|>ost<Tior.  |r.  43 
'.auh.  inner  a■^p^'^■t  of.  44 
Cranium.  36.     St-f  also  SkuU, 
I  crrliralc,  44.   m 
visccrale.  44 
Crt*n>a--ter  niu-..  It  ,  \()o 
^^uiutions  of,  i6j 
n'TVi  suppU  'if,  )/».' 
Crem;'Steri<    fasiia.  I'l^ 
Cre-.t.  JO 

Inn  <  in.H'n,  7^ 

cont  Iial,  *')7,  'kj 

>  th?nnidid,  f>7,  (»; 

foi     rectus    (apiii-    |Kistiiu-    mai<: 

inuM  If,  47 
frf^nt.d,  41.  (m 
infratem|M(ral.  30.  ;  ■ 
lai  hrynial.  .intiii'ii.  (17 

posterior,  0:; 
na-^al,  ftK,  fuj 
o(  t  ipiiiil.  '  \{iTn,iI.  4'' 

inn  tpal,  41.   jf> 
of  ni.ul...  101 
of  lu.id  of  ril)'..  32 
of  ilium.  04 
lips  of,  <;  \ 
nf  n<-<  Iv  of  rill     ^j 
of  puliis,  0; 


'.    Crest  of  sacrum,  29 

of  tibia,  100 

orbital,  of  sphenoidal  Ixme,  50 

sphenoidal,  48 
j    Cribriform  fossa,  232 

plate  of  ethmoid  Ixme,  41,  61,  62 

j  r,,-'    .  ■  41,62 

i    »-"r:    '  ,,  .    >.w    ■...  .■,  43,  46 

\  itw'.i  r-  r     ,   ,4 

j  rf  p;;   -'   .    -. 

I  ;"'-^i'  '■  ■'    >  ■ , 

j       ''   .'    .  ■'■      ■  ■'.•'<  r'      I  [  ^,   22() 

.'    :    ■'.iieni    i'-^iisverse,  2;^j^ 
i    (  n.  -.  a..  '.  <■,  "f   iiaphragm,  165 
inurmediu!,!  of  diaphragm,  165 
lateralo  of  dia|)hr;igm,   if>s 
mediale  of  diaphragin,  1^15 
of  subcutaneous  inguinal  ring,  an- 
terior, I  ^0 
I  inferior.  1 5S 

jKistcrior    1 5() 
superior.  1 5S 
Cubiial  interosseous  bursa,  20S 
t'ulxiid  [nine  of  foot,  K  2.  iO| 

(ieveldpnu-nt.  lof> 
Culxiideonavicul  ir    ligament,    dorsal, 

[  '"*' 

plantar.  141 

j    Cuc\illaris  mu-.c  le.  i  15 

functions  of,  146 
I  nerve  sujiply  of.  !  |0 

I    Cuneifori:;   liones.  evternal.    104 

first,   104 
j  internal.  104 

middle,  loj 
j  *>f  fiKit.  102,  ic; 

i  d  ■vr|(,pment,  lo^ 

j  w'  Ictnd.  >(;.  (JO.  ()i 

I  sei  iind,  Tot 

I  fliird.  10  i 

j        ligaments,  na\ii  1:' M    '■  Txal.  \  \] 
I    Ci:n(-o<  uboid  Iig;.'ii'  11      ,    r>iil,  ip 

inieio^Mous,  1  [  1 
j  piant.ir,  141 

Cuntttmetafitrs.il       ligimt  vu,      ir.ter- 

I  *('.  'COUS,    i  X  t 

Cuneon.'p-ii  >!.■.!  .irlii  LiLnu-f,    :  i-     ■  -s 


In  IP  Ih.m'  ,.;  n,-\or  i-.iii. is  bn\., 

ime-i  It  .   I  'J') 
infrajialell.i;  b'ir-,i.   ! 'v=^ 
l.iycr  of  I  ,df  nius(  les,  J2i 
of  I  er\ii  ai  f.isi  i.i.   i  ;; 
of  e\tensi»ts  of   fnrcarni.  obliiju<  , 
107 
'Straight.  ot7 
of  flt'xi.r  inusi  '<s  of   f.iir.iMii.    ojj 
nuis,  !r^  Mf  tie.  Is,    I  ;; 
|Mtstrrior    ^.11  ro»  o*  *  vgcal    iig.i'VMnt. 

I  '  \ 
leni|M.i.d  fit  1,1.  iS( 
Oehnid  liuainini.  1  Vi 

tub'  [..^ity.  S^^ 
Delloideopeiti-r.il  triangle.  i(.; 
DehoideUs  niUM  I.      iS:     i  .Mi 


Deltoideus  muscle,  function  of,  iSf< 

nerve  supply  of.  1S6 
Uens  epistrop.'iei,  ^5,  2ti,  114 

of  axis,  2-; 
Dental  canal,  inferior,  72 

foramen,  inferior,  72 
Dejiressfir  anguli  oris  mus<  U-.    \<i 

labii  inferiori-i  muscle,  i.'si 

scpti  nasi  must  le.  iSi 
Descriptive  anatomy,  defmition.    1  ?- 
Designations  of  jMisiiions,  17,  iS 
Diameters  of  pelvis,  131 
Diapl'-agm,  i/'j 

crura  of.  1^5 

d'  .    loptnent,  i()() 

foramina  of,  166 

functions  (»!,  j6(t 

nerve  supply  of,  i6fi 
hiai^iiyslal  (enter  of  ossifhaii    n,  21 
lliapbysi.s.  ]<> 
Uiarthioses,  107.  loS.     See  als<»    Ir/n  . 

ulalionx. 
Digastjit   foss.i,  40,  ~: 

mus(  le,   I  4.',  174 
Tunctions  of,  i  7  ) 
nerve  supplv  of,    1  7  j 
Digital  artii  ulations,  i 'S.  1^7,  m.j 

bursa-,  doisal  suIh  ulaneou-.  Jo^ 

fossa.  07 
Digitate  iir.pressir.n>.  4- 

of  sphenoiil  U>ne,  50 
Diploi",  11) 

Disarticulated  skuii.  \h 
Disis,  arlM  nlar,  108,  1  iS 

of  elbow.   I  :3 
Distal  radioulnar  articul.uion.  tj; 
Dorsal  an  h  of  virtibra.  22 

basal  hg.irnenl'-.  i  .>7,  1  1 1 

Ihirder  of  meia<arpal  Ume-,,  ,,i 
of  radiw;   SS 
of  ulna.  .H7 

cairaneona\ii  ui.ir  lig.inient,   i^o 

<arpal  iigamenis,  2o\,  »o^ 

exten-'or     tenrlon     shr.uh-.     be 
ne.nh.  .'03 

I  ar]Mimria(  arpal  lig.nneni.  ]j~ 

(  uUiideonavii  ular  liganieiit.   1  1 1 

<  utu-'H  ulmicl  ligament,  i  1 1 

f.is(ia  of  li.md,  207.  2C.S 

itUenarp.iI  ligament,  i  ,7 

iritert  uiieiforru  lig.imeiit .   i  { \ 

interosset  nuisi  les,   117 

ligaments  of  fi.ot.  1  p 

ii.ivit  ulari  I  uru'ifi  rm  ligament*,  i  1 1 

radio*. irpal  tig.itnc  tit,   1  :ft 

-ubeutaneou^  digital  bur~  i  .  .'oS 
metaiariMiphai.ingv.il   burs.i-.   .>oS 

surfate  of  r.idius.  HS 
of  s.  .ipula,  S^ 
of  uln.i.  Sj 

t.ilonax  i*  ular  lig.tment.   1  (  > 

l.tisai  lig.tmenis,  1  \  ^ 

Iar-.oMiet.il,ir--al  linann  nt-.  1  (i 
I  "irsum.  tnust  'n  ~  of.  2 .;  \ 

^ell.r.   p.   iS 
Douglas'  line,  im 
Dui  (Us  entloluuph.ui-  w-.  ^s 


\^M' 


.MMl 


242 

1  i.HOw,  arlicular  disc  of,  u^ 

articulatii'Ti  of,  122 
Klljow -joint,  122 

movciiR'nts  of,  1 23 
Kllipsoidal  joint,  no 
Kmbryology,  (Icfinition,  17 
Kmint'nt  v,  art  uatr,  54 

artirular,  of  tfnijM)ral  })i)Uc,  40,  ^^ 
carpal,  radial,  (;o 

ulnar,  go 
'  r'lii  iai,  4^,  ^6 
frotual,  (io 
'■;|><ithenar.  iijS 

must  k'^  of,  joo 
ilitipcitineal.  C15 
intiTiondyloiil.  of  tibia,  ()() 
olivary.  41,  4S 
parietal,  ;() 
|)lanlar,  i-.vlcriial,  ?< 
intfrnal,  2;^ 
miildli-.  215.  i^j 
pyramidal.  57 
thenar,  kjS 

nuisi  li-s  of,  it>() 
I"-narthro^i^.  1  lo,  i;^r 
Epitoiul>lcs.  JO 

of  fr.-nur.  L-xlcrnal,  (j-^ 

inti-rrial,  o>i 
of  hiinirrus,  SO 
Kpiiraniu-s  musile.  i  7S 
Kpi|)ltyscs,  II) 
l^liijihysial  rintirs  r,|  ossifu  ation,  .m 

line,  21 
f-'-pisternal  hones,  ^0 
i;pi>triipheii>,  .'!,  .>5 
I'-pilrut  liletKinconetH  must  le.  lo-'^ 
!%rer;or  spinie  nnist  le,  14') 
I'.-ophap'al    openin;;    uf   i!!aplirat;m, 

K),,  166 
I'.tlli  :..i'l  iKine,  6.' 
ala'  of,  fi; 

(riV)riforni  jilale  of,  41.  (o,  '.j 
deVelopnietU  of,  (i) 
"    ,ewl«]rn,  (14,  ,Si 
'  tcral  masses  ef.  t)2,  hj^ 
p(  rpendii  ul:'.  ,  '  11  of,  (>.»,  u^ 
I'.!limi>ii!:il  1p"'1  .,  ') 
ivIK,  (M. 
erest,  67.    " 
depression  .  ci 
foranun.  0^ 
anP  licir,  Oi.  7^ 
[H.,.1.  rj.ir.  (.,,   7- 
i;nHJi<',  ()> 
l,il»\rinlhs,  t'j,  fi; 
n..l,|i,  Oi 
pro<i>s  of  infiri..    ■  uilti.i.tU'i  l-me. 

spine,   t ' .   t'^ 

'iirfae"  o'  l.;i  hrynta!  bone,  t>5 
I'".t!imiiideuma\ill.tij  sutun,  .So 
ru.sl.K  hi.m  tube,  I  artila^itions  iHirli.in 
of,  St 
semi<an.d  for,  sS 
Kxtensor  rarpi  r.tdialis  brevis  nui-,i  Ir. 
iSs,  1    -. 

Itinmis  miisi  le,    I.S:;,    tt)^ 

iiinaris  nuist  le,  1S5,  107 


INDEX. 

Extensor  earpi  ulnaris  mu.scle,  function 
of,  107 
nerve  supjily  of,  107 
di);ili   V  proprius  muscle,    1S5,  U)(> 
function  of,  107 
nerve  supply  of,  ic)7 
dij{ilorum  brevis  miisi  !,■,  210,  224 
communis  niusde,  i.S^.  n^o 
fuTK  tion  of,  i()7 
nerve  supply  of,  107 
longus  nuNcle,  210,  22^^ 
funition  of,  224 
nervt-  >upply  ()f,  224 
halkuis  brevis  mustle,  210,  224 
function  of,  221 
nerve  supply  of,  224 
longus  must  le,  210,  22^ 
funttitin  t)f,  22  ^ 
nerve  supply  of,  22  ^ 
indii  is  |iropriu.s  must  le,    1.S5,  jij.S 
funi  lion  of,  it)S 
ner\e  supply  'if,  iij.S 
of  leg,  22? 

ossis  nietat.-irpi  pollit  is  nuistle,  H17 
ptillit  is  brevis  must  le,  1.S5,  !()7 
functif>n  t>f.  r(j7 
nerve  supply  of,  107 
Itingus  must  le,  iSq.  [97 
fcnction  of,  njS 
nerve  supply  of,  |.;.S 
I        surfatc  of  forearn,.  nuist  les  of.   ms 
I  tif  upper  arm,  nui-t  le  of,   i.Stj 

I        tentions  of  Imgers,  20  i 
ttf  hand,  20J, 
■heaths  ,,f,  20^ 
Il\tern,d  alKl.iminal  ring,  1  s.S 
tirif^'e  of  s,  apula,  s^.  S| 
angular  proi  ess  of  fnHii,il  Ihiuc,    \u 
.iperture  of  ai|uaibii  Ills  vcsiibuli,  ;; 
art  u,ite  liganu-nl,   i  ;0,   if)^ 
,iuililory  nii,[ius,  ^s,  40 
bicipital  grotAf,  i,**s.  107 
iHirtler  .>i  imiiii    us,  Sd 
i,iro;!ii  I'l  ranu  11,  ^o 
I  onil\  !•■  of  lemur,  i>S 

of  libi.i.  If) 
t  rest  tif  libul.i.  I  ni 
•  jneiioini  111. He-  ..f  fcK.i    102,   lo) 
i        epitondylcs  1  '  f,Mi:ur,    i.s 
tif  humerus.  St) 
'm   i.ondyloiil  luiien  le  c  f  li!,;,,,  ,,,, 
iti'ert  osl.d  li'Mnients    i^xj 
il  '•  riosl;ile,  musi  le,.    '.<•■, 

inierniust  ul.ir  sei-i.t  of  .irni.  207 

of  ii.i«h. ,,;. 

l.itrml  Iii;;im(iii  nl  ;in'!.   i  • : 
of  h.-.i.l,   \iS 
of  kr.t'f.  1  ;; 
lunl!^lK.t^Ial  ;irt  h,   td.; 
i;i.»llf«(i.ir  lnir^.u  ^-uln  utJtit'oU'.  .• ;  | 

'-urf.u  f  of  lalu'^.  IC-' 
in;iilrolu-.,  101 
■  Iit;anicnis  i.f,  anlirinr,  i  i; 

)Misurif)r.  (5[7 
in;in;in  of  -.(aimi.i.  S^ 
nuni-(us  n{  knr<-  I  tint,   i  \i, 
in  I  ipii.i!  I  riM.  (f) 

[tmt  iilirraTK  f,    \\.   \(\ 


External  palpebral  raphe,  170 
liatellar  ptinacukim    135 
plantar  enii  ■tntc,  j^j 
pHKL'Ss  of  talcantus,  10,5 

of  talus,  102 
ptery^ioid  plate,  40,  50 
rcctu>  mustle,  'ipine  for,  76 
semilunar  rarlilaftc,  133 
sulHutanei)US     t-pimndvlar     l)ur>a, 

su|)erior  articular  surface  of  tibia. «,() 
surfate  of  shaft  of  tibia,  100 
talo(  all  am-al  li^anu-nt,  140 

IuIkTi  Ir  of  talus,    lOJ 

Kxtremities,  lower,  Inirsa'  of,  2_^^ 

fasci;e  of.  2.:ji 

free,  skeleton  of,  07 

tnust"k-s  of,  2o<) 
elu^situation.  2_j,^ 

skeleton  of,  S»,  cj^ 
of  lon^  IkmU's,  ii> 
skclelctn  of,  2J,  Sj,  S^ 
upper,  artieulation?-  of,  i  n) 

bursa'  of.  20S 

fascia'  of,  207 

frte,  skeleton  of,  S:; 

ligaments  of,  1  i<) 

museles  of.  185 
flevi  lopment,  201) 

-skeleton  of.  S_>.  K^ 

thora*  ir  riiu-«  le^  of,  166 


V\(V,   bon^■•^  of,    (  I 

must  les  of,   I  7S 
funttioti^  of.  iS_' 
nerve  ■^uppl\■  of,  iSj 
proper.  i;.j 
i  .!(ial  eanal,  5'>,  >7 
f^enieuluni  of.  57 

surface  of  malar  hone.  71 
1  all  itorm  marj;in  of  fasi  i,i  lata,  2^2 

process,  i2t) 
I'al^e  j)elvis,  i ^o 

rib>,   I  J, 

vertebra-,  22,  2X 
Ka-..  ia-.   r  j^ 

ai"!oniinaI.  i^; 

aiiiibrai  hia!,  J07 

axillary,  207 

braeliial.  J07 

buetojtharyni'e.il,  iS.; 

terviial.   1  77 

»  orat  ot  i.ivit  ular,  i  70 

I  rema>t(  rii  .   i  '•  ( 

(ruri>.  2  {-^ 

^iul.Ml.  21,2 

iliai  .  2  \\ .  :  \2 

iliope)  tineal,  2  \i.  j^* 

infra^pinatu-^,  -'07 

lata,  2i,\ 

himlMxIorsal.  i  i<i,  1  ^C) 

iunhal,   i;'> 

of  i)ai  k.  I  ;f) 

of  f.«.i,  ..(^ 

of  hand,  dorsal,  20";,  .-•oS 

of  lirad,  1S4 

of  leg,  2,.? 


INDEX. 


243 


Fascia;  of  lower  txtrcmity,  231 
of  nt'ik.  177 

of  tliij^h,  2^1 

of  iipiKT  rxtrmiity.  J07 

[Kiroti'ironiasst'Urii  ,  1S4 

JH'ttilU  .ll.   2_J,2 

piTtor.il.    t  ;o 

jiri-viTiihnil,  177 

Scarpa's,  ih^ 

suhsv  apular.  J07 

^upt•r^nial.  ^t-iura!,  i6^ 

supras|)in.itus,  .'07 

ltin(M)ral.  1S4 

iransviT^aiis.  U»t 
Kaxituli,  transvtTsi',  jri? 
l-at  tnas^,  Iliihat\,  iSj,  i8^ 

hut  cal.  iSj?,  iS; 
Finiali'  iH-Ivis.  1  :;i 
i'Viiioral  lotnUI  -,  155 

Irianiilr,  .'ifi 
I'Vinur.  Sj,  07 

tcnniyk's  of,  gS 

<i(\(-!i»pinfm.  i)A 

rpi,..MtivIi-.  of,  (,S 

fXtnniitM-  of.  ()-.  <)H 

lu-aii  <.f.  07 

m-t  k  of.  07 

^hafl  nf.  .,7,  i).S 
^urfa<  I-'  nf,  1)7,  ()S 

surfai*^  *ti.  ()7 

triK  h.inliTs  <if.  {)7 
I'Vnt-'lra  <    ali--.  >; 

vr<uliuh,  ;; 
Kt-nrstration  of  ril^,   i(» 
KilKTs  of  suIh  utamous  infruinal  rinj;, 

ISO 
I-ilinM  artilam-,  inttT)>ulii<  .  loS,  ijS 

intcrvirti  hral.  loS,  1  ro 

na\iiiilar,  141 
Kihrous  l.iytr  of  ariii  ular  (apsiiU-,  loS 

rin^  of  iMttr\<rltliral  lit)ro<artilau< , 

I  JO 

riiiula.  Sj,  loi 

and  til)ia,  rcl.iiion^,  lOi 

apex,   to  I 

ar!iruiation<  of,  i  ^h 

iH)riitT--  of.  ioi 

I  M  sis  of,  101 

dcvrlopim-n'.  101 

r\iM-inili(s  of.  loi 

hfai!  of.   roi 

inlcro-.M'ou-'  nu  niliranc 

sh;ifl  ..f    m, 

surfai  is  of.  IOI 
liliular  Litt  lai  li|ianu'nt, 

noil  ii.   ion 
I'inmi  ioinis.  I. '7 
I-inKiT'-.  hone--  of,  i}2 

fxitiisor  Uinion-.  of,  ?04 

?iit»\fmtnl-.  of.  1  .•7 

synovial  -Inalli'-  of.  .>c!:; 
I-'irst  (iiiiriforni  l>onr  of  fiM,).  10  i 
Kis.sura  iMiroiympanit  a.   10.  >  ?.  5 
I■i^^^lrt■,  (it.iM-rian,  \o.  5  ^  ;7 

infitior  orliital.  17.  VK  '•''.  7'.  7 

infundilM'hr.  t*\ 

,Miroo, »  ij)ii;il.  40.   n.  51,  ,Si      ■ 

|»(  lros<(iiam(»^al.  ;  ^,  54 


M.  i.V'.  ".*; 


'.M.   i.vS 


Fissure,  petrotymiiai'i.  40.  51.  57 
s])ht'noi<lal,    ^7.  42.  41)    74.  75 
sphenomaxillary,  ^7.  _^o,   71,  74.  75 
sjihtniMwripitai,  4=1 
s[>ht'nojK'lrosai,    ^k    1'='.  4--   >  *•   ^s- 

.Si 
superior  orhital,  37,  4*.  40.  71,   7i 
tyupanomastni;!.  51.  57 
tynipanos(|uainosaI.  ^j 
Fixation  lii^anuni^.  loS 
Flat  .lUloniinal  nui"!  Irs,   [:;7 
(ie\  flopiiictit.  i*)^ 
iMme--.      J 

must  I.  >  of  h,i(  k,  145 
(levclopnu-nl,  15O 
l-'lexiori  vrt"  lira-.  2  ^ 
Flexor  ae(essi.rius  niU'i  le,  2.'-'5 
hrevis  iji^ili  \'  niusi  )e.  21  .• 
larpi  ratliati-.  imum  le.   iN^.  imi 
funi tion  'if.   itji 
nerve  siipjily  of.  !-)[ 
u.nari^  musi  le,  iS;,  i()> 
funetion  of,  i<)j 
neive  --upply  of.   \u2 
dit^ili  quiiili  hrevis  nm--  le.  iSo,  :oo, 

-  - 1 
fuin  'ion  of.  .^  -.o.  2.^7 
ner\e  ^t;p|'t\ ,  .'oo,  j.'7 
ilit;iloruni   hre\  i  -  niu-t  le.   _■  tc.   2.'^ 
nerve  sajiply  of,  22^ 
lon^u-'  inusile.  Jio,  2i(),  22\ 
funi  lion  of.  .'.•  > 
nerve  supptv  of.  222 
profundus  nui-t  le.   iS-;.  oji 
fnm  lion  of.  loi 
ner\.-  --uppl)  ol.   m  j 
■-uhlinii'^  niu^*  le,  |.S>,   I  f).' 
lurn  lion  of.  ro-' 
ner\  \   --upph  of.  m  j 
liallui  i--  hre\  i^  inu-t  le    j  10,  jjO 
funi  lion  of.  220 
ner\e  -upply  of.  22U 
l<»n^us  nui--i  le.  2\o.  210.  222 
fuiM  tion  of,  222 
)rCiMi\v  for,    to^ 
nerv*'  -upplv  "f.  :?--• 
nf  liiiph.  21S 

|Hillii  is  hre\i^  nui->t  le.  1 S^,  \m) 
funi  tion  of.  ii}<t 
nerve  -uppiv'  of.   100 
lonj^u-  nui-»  le.  r >^;.  lo^ 
fnm  lion  of,   i.,  j 
nerve  -u|'ply  of.   nj  1 
surfaie  nt  (oreann.  must  les  uf.   iiji 

ol  upp'  r  arm,  1  lu-i  les  of,  iSS 
tendons  of  p. dm,  205 
llo.iiiuLi  rih-     .  ^ 
l-'onlantiU'.  s ! 
mlerior.  Si 
fr.intal.  Si 
m,a-toii|.  S» 
o(  ( ipiial.  Si 
jHMerior.  Si 
sphenoidal,  S2 
I'ontii  nli.  Si 

l\nii.  .iriii  ul.ition-^  of.  1^7 
U.ni's  of.   101 
eaUaneus  of,  loj,  10^ 


Foot,  lulxud  Umt*  of,  102,  104 
euneiform  iMines  ol,  IC2,  104 

fast  i;e  of,  2i,_\ 
ligaments  of,  1^7* 

auessorv.  \  \f} 

inlerossenus,    141 
hmdirit  lies  must  les  of.  22S 
niiiatars.it  fmii'-^  of.  10^ 
nuisi  le*-  of.  224 

t  la->irii  .ition,  2  iS 
navii  ular  Uine  of,  102.     o\ 
phaiam^es  4»f,  S2,  ic; 
se-an.oi»!  hones  of,  S2,  lofi 
skeleton  of,  101,  io(' 

sole  nf,    l-;iJ.|^(  Irs  of,    2  J  ; 

syaovi.ii  -heath-  of,  22t) 

talus  of.     1.^2 

tarsal  hones  of,  102 
xaj^inal  ii;.^anient~  of,  2;i 
I'oramina,  20 
alvmlar.  U- 
anterior  -.h  ral,  .:- 
auililnry.  internal.  55 
(  ai  um.  41.  ^M  .  So 
(  aroiid.  exiernal.  ;/» 

intirn.d.  ;; 
I  n-ioir.in-\er^t  .117 
dental,  inferior.  72 
ethiimirlal.  6; 

anterior,  (>i .  75 

I«i-lerior.  'm  .  -:; 
front. d.  f)'".  7-;,  ;'» 
ini  i--i\  e,   ;o,  ''S 
infraori'ital,   ^7,  ('H.  (17 
interverlehial.  2  \.    \\ 
iuj^ular,   11.  1  ^  \(i 
Lif  eruin,   ;().   j-i.   (.-.  n,  5^ 
ma^nuhi,  40.   ( \.   1^ 
itLUidiindar.  72 
in.iMo'.!,    ,0    ;;.  Si.  51 
mental.   ^7.  ,  2 
na-ai,  ''5 
miirien',  20 

of   hn„r.    -n 

of  lilii.t.   100 

.►f  ulna.  S7 
ohiur.ilor,  o;.  o'l 
of  di.iplu:igm.  U'') 
<A  na-al  i  .i\ity.  7, 
>i  -ji  rum,  iiiK  t  verl(  hial,  20 
of  -i< mum.   \f' 
ol  xii-hoid  pro<  I  -s.    ;() 

o|.tii .  (f.  )S.  :^ 

ovale.   ;.;,  4:.   10.  so 

p.liatine,   L'leatel  ,  40.  (n) 
I'-'-'vel  ,     j.i,    70 

)uri<  t,d,    \\.  50 
<|u.idri'aiera!.  i(tO 
mtmidum,   \2.  to.  50,  7S 
sairal.  2S.  20 

interxerli  hr.d.  2n 
^Ai  ro>i  i.idc  .  I  \''- 
-I  iatii  .  ^ncil.   I  \o 

le--ser.   I  ^o 
-pheno|>aIatine.  7c,  7H 
sliinal,  2  ^ 

spino-um.  \ii.  \2.  10.  50 
stvloma-loiil,   \v.  ;fi 


-,*,-T- 


ii 


T-''<* 


244 

Foramina,  su;>raorbiial,  60,  75.  7ft 
transvtTsarium,  24 
vertehrak',  2^ 
zyKiimatii-ofarial.  yt 
zyg()inatinM)rl>ital,  y  •. .  75 
/yg<>m.iiitotfmjK>ral,  71 
Forearm,  extensor  surfare  of,  mus<  Ir^ 

of,  ii)S 
flexiir  surface  of,  niiiseles  of,  igi 
muscles  of,  1S5,  i(>i 

classification,  20() 
radial  musilcs  of.  i()i 
Foreheail.  Uiny,  ^l> 
Fossx,  20 

acetabular.  ()6 
anterior  «  ranial,  41 
axillary,  147 
canine,  dd 
carotid.  172.  174 
condyhiid,  45 
coronoid.  .S6 
cranial,  41-4? 

anterior.  41 

niddlc,  41 

IK)sterior.  11.  4.5 
cribriform.  .',^.' 
di^ia.stric,  40.  72 
.IJKiial.  (17 
for  lailirvnial  nl-""'>  7* 

■-ai  ,  7''i 
Ulenoiil.  ,?S,  yt 
liypo(;lo-.s.il,  4S 
hy|«o|il>y^c,il,  41 
iliai ,  115 

iliopei  lineal.  210 
infras]iinalou-i,  of  siapula,  H) 
infratemporal.  7() 
intercondyloid,  ()8 

anterior.  ()<) 

postirinr.  i|i) 
juKular,  in.  |(i.  50 
niandibul.ir.  ^.S,  |o.  55.  iiS 
niastoiil.  ;i 
tniddle  t  r.oii.il.    p 
•  mipilal,  inferior.  4  (.  40 

superior.  4'i 
olecranon,  S7 
oval,  -vt-' 
pelrusil,  5'> 

|io^n  rior  cranial,  41,  41 
pler\4ioit!.  40,  5 1 
ptervxo|i.ilalin. .  40.  ^o.  7,S 
radiiil.  S7 
.s(  aplioul.  51 

!«|ilteiiom.i\ill.ir\ .  4'i.  50.  7.S 
nulKiri  uali .  s; 
sulisiapul.ir.  .■<( 
.siiprai  l.ivii  uf.ir.  lesser,  171 
Hupraspinalou^.  "»f  s(apul.i,  Ht 
temiioral.  i-'^i  ^J 
triK  hant*  m  .  07 
/.VKomatii  .  71) 
FoMM.   ..n 

arti<  nl.iri^  dentin,  :^ 
I-o\iH(I.e  yr.imilires.  ^^,  i)o 
Free  lo«el    < MreniilV.   --kel'Mon   of.   07 
Ujiper  e\trelillt\.   skeielon  of.    is., 

F'rons,  4(1 


INDEX. 

Frontal  angle  of  parietal  Iwne,  51) 
bon. ,  ^<),  60 
Ixirders  of.  ()o 
cerebral  surfaces  of,  41 
development  of,  62 
frontal  [jortion  of,  60 
ill  ne\  ')orn,  62,  81 
nasal  portion  of,  Ao,  61 
orbital  plates  of,  61 
surfaces  of,  61 
suit  i  arteriosi  of,  61 
surfaces  of,  60 
zygomatic  jirocess  of,  60 
iHinler  of  parietal  bone,  5() 

of  sphenoid  bone,  41) 
cells,  (\\ 
crest,  41,  ft  I 
eminences,  fto 
fontanelle.  Si 
foramen,  fio.  75,  76 
notch.  60,  75 
plane,  17 

|«)rtion  01*  frontal  iMine,  60 
process  of  maxilla.  ,^7 

of  sujierior  maxillary,  6^,  67 
sinu'.,  61 

development,  f)2 
sjiine,  ft  I 

surface  of  frontal  l«ine,  (to 
suture,  (to,  .Hi 
Fronlali*  mus.  li'.  17.H 
functions  of,  1  7.S 
nerve  supply  of,  1  7S 
FrontiKthnviidal  suture.  41,  (it,  .So 
Frontol.idirymal  suture,  (7,  .So 
Frontoin.ixiilary  suture,  ,?7,  i'o 
Frontosphinoiiial   process,  57,  71 
Fusiform  mu-cle,  142 


G.M.K.x  a|«>neurotiia,  17.S 
(rasirocnemial  burs.t.  inner,  220 

nilernal,  1  ^ft.  220.  2(4 
(lasirocnemius  lateralis  niusile,  220 

nieilialis  muscle.  220 

niu--!  le.  211) 
(lenielli  mii^i  les,  201).  .' 1  i 
(iemellus  inferior  nuisi  !e,  214 

su|HTior  nnisili'.  21  \ 
(leneral  .m.ilomy,  delinilion.  17 

su|K'rfii  i.d  fa-iia.  ift) 
Cieniculum  of  f.n  i.d  caii.d.  ^7 
(ienioliV'iidcus  niu^i  le.  171,  17; 
fum  lion^  of.  17s 
nerve  su|.|ilv  111,  17:; 
Ciimlx'rnat's  li(tameiil.   iti.    I'n,  lOj, 

-Ml 
llinnlvmoaiiliri»lia.  127.  i  to 
CilnKlvinus.  100 

later. il.  io<) 
Cfinlle.  pelvic.  ()( 

anil  ulalioii,  of.  12H 
lipianieni-  of,  i  2S 

shoulder,  .s^ 
C.lalM'lla.  fv.i 

I'lladiohi^  of  -lemuiii,  \4 
to.ind,  i.HfMvnt.ti,  [o„,.,i  I«tr,  7n 
(ikseriun  lissurr,  40.  5,A,  57 


Glenoid  cavity,  84,  121 
fossa,  38,  55 
ligament,  121 
Glenoidal  lip,  108,  io<),  121 

of  hip,  131 
Gliding  joints,  1 10 
Glut.Tus  masimus  muscle,  200,  211 
function  of,  21  2 
nerve  supply  of,  212 
medius  musile.  20<),  212 
function  of,  21  2 
nerve  sujtply  of,  212 
minimus  muscle,  20<),  212 
fun(  tion  of,  212 
nerve  suppiv'  of,  212 
Gluteal  fascia.  2_^2 
line,  anterior,  ()4 
inferior,  1)4 
middle,  ((4 
jiosterior,  ()4 
superior,  ()4 
muscles,  21 1 
sulcus,  2,^2 
tulKTOsity,  q8 
Gluteofemoral  burs,T,  212,  2,5? 
domphosis,  107 
Gracilis  muscle,  2tx),  2i() 
funition  of,  217 
nerve  supply  of,  2 1  7 
Great  sacrosciatic  ligament,  I  2(( 
saphi'nous  vein,  ;,u 
sci.itic  foramen.  1,^0 

nop  h.  1)4.  ()(> 
UK-,  ball  of.  muscles  of,  226 
Greater  icirnua  of  hyoiil  iKjnc,  7.5 
multangular  Imne,  .S<),  r)o 
palatine  foramen,  40,  (»> 
pelvis,  1^0 

sigmoid  notch  of  ulna,  S7 
troihanter,  (17 
tulierile   )f  humerus,  85 
tubircular  ridge,  8ft 
wings  of  s|.henoi<l  iMine,  47,  41) 
Groove,  111' ipital.  external,  188,  207 
internal.  i.S.S.  207 
of  liunienis.  85 
(arotid,  41,  48 
carp.il,  00 
•  osial.  42 
.■Ihinoidal    (i, 

for  ll(  xor  h.ilUiiis  longus,  lo.? 
for  nius«  ulospiral  nerve-,  86 
for  i.idial  nerve,  8ft 
haimll.ir.  51 
infraorliilal.  (>ft,  7ft 
imerlulH-n  ular,  of  humerus,  85 
lai  hryni.il.  <i7 
miisculo^piral,  80 
mylohyoiil,  72 
obturator,  (15 
of  calt  aneus,  104 
of  prtimontorv,  58 
of  i.ilus,  102 
oiHii.  ti,  48 
p.alaline.  ItS 
paraglenoiilal,  o? 
prr.inca:.  ic,;.  i"} 
(K'lriwal,  inferior,  4t.  45,  SS 


INDEX. 


245 


Gnmvc,  j)etrosal,  superior,  43,  55 
ptiTyRop;ilatinc,  51,  67,  69 
pulmonary,  35 
sagittal,  44,  46,  60,  61 
sij;moi(l,  43,  40,  53,  60 
sulx'lavian,  33 
transviTSf,  43,  46 
tympanii,  57 


Hai.i.f.r's  arches-,  1(15 
Hainatf  Ixinc,  8<),  (|0 
Hamatonuiacarpal  liganicnl,  127 
Hamular  gro<jVL',  51 

])ro(i'ss,  4c,  5t 
Hamulus  lai  rimalis,  65 
pro'.i'ss,  ()0 
ptcryBoidi  us,  40.  51 
llami,  artiiulatioTis  of.  124 
Ininrs  of,  S() 
carpal  l)o  ics  of,  Sij 
extensor  tt  ndons  of,  203 

sheath-  of,  203 
ligaments  of,  124 
metacarpal  <M)r.es  of,  i)I 
movements  of,  12O 
must  les  of,  185,  i(>S 
ciassiluation,  201J 
palm  of,  tendons  cif.  205 
phalanges  of,  82.  ()2.     See  also  /'/;,/ 

iiiflt^rs  11}  hiiful. 
sesamoid  hones  of,  82,  i|2.     .Sec  .iNo 

Sesamoid  hours  oj  Intmi. 
skeU'ton  of,  ()2 
Il.inl  palate,  3.).  t<H,  7S 
in  newlM>rn,  'hj 
tulHTOsily  of.  40 
[farmoni(  suture,  107 
Head.  arti(  ulalions  of,  1 17 
fas(ia'  of,  1H4 
ligar'U'nls  of,  1 17 
independent,  i  iS 
mus{  les  ()f,  177 
of  I  Mines.  20 
of  femur,  07 
of  hliula,  101 
of  humcru'-,  Xs 
of  melam.pal  Ixmes,  01,  02 
of  nn-tatarsal  iKines,  10s 
of  must  le,  142 
of  radius,  88 
of  rilis,  ^1 
of  scapula,  8) 
of  lalus,  102.  T03 
skeleton  of,  i:.  3() 
Ili.ilu-,  20 
lan.ili^  faiialis,  4;,  s» 
Kallopii.  43.  54 
seniilunari-,  (14,  7S 
Hinge  joint,  icxi 
Hip.  must  les  of.  210 
,  lassilu  atitin.  J  i,\ 
internal.  210 
Hip  joint,  131 
anil  ul.ir  ia|)sule  of,  132 
glenoid.d  lip  of.  I  <i 

Horizontal  plane.  17 


Horizontal  plates  of  palate  1hv.ii    (x) 
lK)rtion  of  hani  palate,  30 

of  sijuamous  jMjrtion  of  teni|mral 
l)one,  52 
Homer's  muscle,  170 
Humertl  head  of  flexor  car]ii  ulnaris 
muscle,  102 
digiliirum  sulilimis  muscle,  102 
jHillii  is  liingus  musi  le,  t()4 
of  pronator  teres  muscle,  iiji 
Humeroradial  articulations,  122 
llumeroulnar  articulation,  122 
Ilumertis,  82,  85 

anatomical  net  k  of,  85 
iHpnlcrs  of,  8(1 
development,  87 
extremities  of,  S^ 
head  of,  85 
neck  of,  anatiilllical,  85 

surgic  al.  80 
shaft  of.  85 
surfaces  of,  80 
surgiial  neck  of.  86 
tulxTcles  of.  85 
Hunter's  laii.ii.  21  7 
Ilyoid  hone.  73 
Ixuly  of.  73 
(levelopnienl.  73 
ligaments  of.  1  it) 
mvisi  Ic-s,  172 
llv|Miglossal  tanal.  40.  4S 

•foss...  48 
lit  popliNscal  fossa.  41 
ily|Kiphysis.  j8 
Hy|Kiskcletal  muse  li  s,  i(i| 
lly|pothen,ir  eminence,  ic),S 
mustlfs  ol,  200 


!    Ii.lM-  liiirs,!,  sulilc  ndinous,  234 
I        fascia,  231,  2,11 
I        ft>s.sa,  QS 
'    Hiatus  mustle.  210 
Ilioi -tstalis  ccrvicis  muscle,  14C1 
ilorsi  muse  It .  1  |cj 
lumlK>runi  muse  Ic-,  1  10 
must  le,  1 41) 

functions  of.  i;t 
nerve  suppiv  of,  1  SI 
lliofi  iiior.il  lig.imcnl.  1  ii 
IlioluMili.ir  lig.imeni.  121) 
Iliopct  lineal  Imrsa.  133,  211,  2(4 
eminent e,  t); 
fascia,  331,  ii,! 
fossa.  210 
ligament,  231 
line,  OS 
Illiipso.is  ntustle,  200.  210 
funttion  of,  21 1 
nerve  supply  of,  21  1 
llioiiliial  hand.  .•}-• 
Ilium,  CJ3,  o) 
ala  of,  1)3,    01 

surfaies  of,  04,  c)S 
IkxIv  of,  lis 
crest  of.  1)4 

lips  ..f.  ..4 
ileMlo)iment.  c)6 


Iliun),  spines  of.  04 
tulierosiiy  tif,  c)S 
Incisive  f,)ramen,  31),  68 
must  les,  181 
r   iih.  <>8 
s    'urc.  t>i).  8t 
Int  isor  teeth  in  fclus.  (x) 
Incisura.  20 

mastoidea.  40 
Independent   ligaments  of  he.itl,   118 
Incliiator  muse  le,  li)8 
Inferior  .ingle  of  st.ipul.i,  83,  8( 
aperture    if  pelvis,  131 
artitular  surfat cs  of  tihia,  100 
helly  of  omohyoideus  must  le,    171 
liitipilal  hursa.  234 
tornu  of  fasc  i.i  I.Ua.  232 
t  rus  of  siilic  uianeous  inguin.il  ring, 

158 
tienlal  tanal.  72 

foramen.  72 
extremity  of  femur,  07,  cjS 
surfac-es  of,  t).S 
of  lilnila.  101 
of  humerus,  85 
of  radius,  81) 
•  if  lihia,  00 
of  ulna,  87,  88 

glute,ll  line,  lit 

inlerverteliral  notch,  2; 
maxillary,  71.      See  aKo 
meatus  of  nose,  77 
nut  hal  line,  41,  40 
01c  ipiial  foss,i,  4  1,   |0 
orliiial  lissure.  37.  30,  'Ki.  7 
perime.il  retin.ii  ulum.  230 
petrosal  groove.  43,  45.  ss, 
pill.n  of  sulii  uianeous  inguinal  ring, 

158 
prcH  c-ss  of  icnipiiral  hone,  57 
puhii*  ligameiU,  I  28 
ramus  of  ist  hium.  cjj 

of  puhis.  03,  c)(i 
temporal  line.  S') 
thoratic  aperliire.  tS 
transverse  ligament,  121 
turhinateil  Inine.  64.  67,  77 

ilevelopincni,  (14 
\ertehral  nolc  hc-s.  2  { 
infr.iglenoiil.il  margin  of  tihia,  mo 

lul«rosiiv,  8| 
Infrahvoiil  mii^c  li  s.  172 

fum  lions  C.I.  1  7  I 

nerve   supply  of.  173 
Infr.iiirliil.il  i.inal. 

1  nirance  of.  7v 
for.imcn.  37,  '»6,  67 
grcKixe.  ''/).  76 
ni.irgin.  7s 
siilure.  '18,  81 
Infr  ip.  o  ll.ir  hursa.  dc-ep.  1  ;s 

siilii  iii.iniiiiH,   136,  231 
Infraspinatus  hursa.  20H 
f.isi  la.  207 
fossa  of  siapul.i.  H; 
must  le,  1 8s.  ISO 

fun'  lion  "1.  17 

nerve  --uppl'  "I,  i>7 


M.imlMr. 


71.  7s 


246 


InfrasUTnal  angle,  35 
Infratrniporal  crest,  ,{(),  50 
fossa,  "(> 

surface  of  sphenoid  iMjne,  50 
of  superior  niaxillary,  66 
Infundibular  fissure,  64 
Inguinal  canal,  r5(> 
ligament,  131.  it\^ 

reficcted,  I5().  164 
ring,  sul)cu'.';neous,  1 58 
Inner  1  rura  of  diaphragm,  165 
ga^lnHnemial  bursa,  220 
head  of  gastrocnemius  muscle,  220 

of  triceps  muscle,  iijo 
lip  of  tinea  aspera,  ()7 
portion  of  longus  colli  muscle,  17O 
vitreous  table  of  flat  bones,  19 
Innominate  bone,  (13 
development,  06 
Inscriptions,  tendinous,  143 

of  rectus  abdominis,  161 
Insertion  of  muscle,  142 
Interalveolar  septa,  68 
Interarticular  cartilages,  los 

ligament,  ir6,  117 
Intercarpal  articulations,  124 
ligament,  dorsal,  127 
volar,  127 
Intercartilaginei  ligaments,  i6q 
Interchondral  joints,  117 
Inten  lavi<uh)r  ligament,  iii) 

not(h  of  manubrium,  14 
Iniercolumnar  libers  of  suIm  utaneous 

inguinal  ring,  15c) 
Intercondyloid  eminence  t>f  tibia,  ijc) 
fossa.  oH 
ant*'rior,  (j<> 
lK>sterior,  gt; 
line,  i)H 

tuln-rt  le,  external,  tut 
internal,  i)() 
Intercostal  ligaments,  117 
external,  ifx/ 
internal,  i(«) 
spa-e^,   ;; 
Inli-r(o-,i.ilc>  extern!  niu^iles,  161) 
interni  nuistles,  i(x) 
muscles,  !<>(),  I'm 
functions  of,  I  70 
nerve  >uppl.v  of.  170 
Intercrur.-d  tit>ers  of  ^ubi  ul.ineous  in- 
guinal ring.  150 
Interi  unciform    ligament,  dor-.il.   141 
iaten»sseous,  141 
plantar,  141 
Intcrnuixiilar)'  Iwtnc.  fxj 

suture.   17,  ,So 
Intermetlial  crus  of  di.tphragm.  105 
In:    -met.-H  arpoplial.mge.il  bur^a',  200 
Inlermclatar'i.il  anil  111. iiions,  1(7,  1  ^i) 
Inlermel.itar^oph.dangc.d    burs.i.    2^5 
I.ilerttui--<  ular  sept.i.  1  ^  \ 
anterior,  of  leu.  .•(( 
external,  of  arm.  207 

of  thigh    2^1 
internal,  of  arm.  iSH.  207 

of  thigh,  2\2 
of  .If  Ml-,.  18S.  20; 


INDEX. 

Intermuscular  septa,  posterior,  of  leg. 

Internal  angle  of  scapula,  83,  84 
annular  ligament,  231 
arcuate  ligament,  165 
auditory  cani>l    53 

foramen.  55 

meatus,  43 
bicipital  grcMive,  188,  207 
border  of  humerus,  86 

of  tibia,  100 
rarotiil  foramen,  55 
cerebral  surface  of  frontal  lx>ne,  60 
condyle  of  femur,  g8 

(ii  tibia,  (>() 
crest  of  libula,  10: 
cuneiform  bones  ot  fo<it,  102,  104 
cpicondyle  of  femur,  qS 

of  humerus.  86 
gastrocnemial  bursa,  136,  220,  234 
intercondvloid  tubenle  of  tibia,  170 
intercostal  ligaments,  169 
intercostales  muscles,  i(x) 
intermuscular  septum   of  arm,  1.S8, 
207 
of  thigh,  232 
lateral  ligament  of  knee,  i  u 

of  radius,  122 
lumlxwostal  arch,  16:; 
mallef)lar  bursa,  sulKutaneous,  234 

surface  of  talus,  102 
malleolus,  too 
margin  of  scapula.  S^ 
meniscus  of  knee-joint,  133 
musiles  of  hip,  210 

of  thigh,  216 
occijiital  crest.  44.  46 

protuberance,  44,  46 
pal|R'bral  ligament,  171) 
patellar  retinaculum,  I.VS 
plantar  emineni  e.  233 
prtK-ess  of  calianeu^.  10^ 
pterygoid  plate,  40,  50 
semilunar  cartilage,  133 
sulMUtaneous     epicondvlar     bursa, 

20S 
suiH'rior  articular  surf.uc  of  tibi.i, 

surf.ue  of  shaft  of  tibia,  100 
of  ta!u->'.  102 
of  uln.i,  H7 
tal<HaKaneal  lig.iment.  140 
tubercle  of  talus.  102 
Iniernasal  suture,  37.  6^,  80 
InleriKi  ipilal  >ynihonilrose-.,  47 
Interossei  itor'^ales  muscles,  1H6,  200 
fum  lions  of.  20  ( 
nerve  supply  of,  2C\ 
ntusi  les  of  f«Mt|,  210,  227 

of  hand.  iHli,  200 
[M'dis  mu-.!  les.  227 
dorsid.  227 
fniH  lions  iif,  22S 
nerve  -apply  of.  228 
plant. ir.  227,  228 
volares  muscle-,  186,  200,  201 
function  of,  303 
nerve  sup|»iv  of,  203 


Interosseous  basal  ligahunts,  127 

metatarsal  ligaments,  141 
bursa,  cubital,  208 
cuneoculxiid  ligament,  141 
cuneometatarsal  ligaments,  141 
intercuneiform  ligament,  141 
ligaments  of  f(M)t,  141 

of  neck,  1 16 
membran''  of  ra<lius  and  ulna,  I2j 

of  tibial  and  fibula,  136,   137 
ridges  of  tibula,  loi 

of  radius,  88 

of  tibia,  TOO 

of  ulna,  87 
sacroiliac  ligament,  r20 
spaces  of  metacarpal  bones,  02 
tai(H\alcaneal  ligament,  140 
Interphalangeal  articulations  of  foot, 

',??■  '3') 

of  hand,  128 
Interpubic  fibrocartilage,  108,  12S 
Intersphenoi<lal  synchondrosis,  51,  81 
Intcrspinalcs  muscles,  154 

functions  of.  155 

nerve  supply  of,  155 
Intcrspinous  ligaments,  1 1 2 
Intertarsal  articulations,  137 
Interlransversarii    anterior    muscles, 

laterales  muscles,  155 

mcdiales  muscles,  155 

muscles,  154,  155 
functions  of,  155 
nerve  sufiply  of,  155 

[HKteriores  muscles,  155 
Intertransverse  ligaments  of  vertebral 

itilumn,  1 1  2 
Intertrochanteric  line,  97 

ridge.  97 
IrnertulMTcuIar  gnxive  of  )      -lerus,  85 

mucous  sheath  of  biiep>,  .  ji,  188 
Intervertebral  discs,  30 

fibrocartilages,  108,  no 

foramen,  23,  31 
c)f  sacrum,  20 

joints,  1 1 1 
Intrajugular  pfxess,  46,  55 
IntraiKt  ii'ital  svni  hondrosis,  anterior, 
81 
posterior,  81 
Inlratendinous  olei  ran.il  bursa,  208 
Irregular  l>ones,  20 
Isthiocapsular  ligament,  132 
Isihiuin,  03,  ()6 

de\'elopment,  96 

Jaws.     Sei'  Mamlihle  and  M.ixilUr. 
Joint.     See  ArtUutiiliimi. 

lu-hions.  108,  itx) 
Juga  alveolaria,  68 
Jugular  foramen,  40,  41,  4( 

fossa,  40,  46.  s6 

nod  li  of  manubrium,  34 
of  ti-mporal  Innie,  55 

prixess.  43,  46 

tul«'ri  le-.,  43,  46 
Jugum  sphenoidale,  41,  48 
Juucluro;  lenduiuin,  196 


INDEX. 


24/ 


Knee-cap,  gg.    Sec  also  Patella. 
Knee-joint,  1,53 

menisci  of,  133 
funrtions  of,  13'' 

movements,  136 

semilunar  cartilages  of,  133,  136 

transverse  ligament  of,  134 


Lacertus  fibrosus,  iXH,  207 
Lachrymal  bone,  37,  64 

development.  65 

surfaces  of,  65 
cells,  63,  65 
crest,  anterior,  67 

posterior,  65 
gland,  fossa  for,  76 
grtxjve,  67 
notch,  67 
portion  of  orbicularis  txuli  muscle. 

pnx'ess  ftf  inferior  turbinated,  /)4 
sac,  fossa  for,  7(1 
Lachrymoconchal  suture.  80 
Lachrymoethmoidal  suture,  .So 
Lachrymoma.xillarv  suture,  80 
Laciniate  liganu-nt,  231,  231 
Lacuna  musculorum.  231 

vasorum,  231 
Lacunar  ligament,  131,  if>3,  164,  231 
Lambdoid  border  of  occipital  bone,  46 

suture,  38,  7q 
Lamina  papyracea,  6? 
Langer's  muscle,  1(17 
Lateral  crest  of  s.t  rum,  2(, 
crus  of  diaphragm,  1(15 
ginglymus,  loq 

i..tertransversarius  muscle,  155 
ligament,  external,  of  arm,  122 
of  head,  1 18 
of  knee.  13S 
fibular,  134,  135 
internal,  of  arm,  122 

of  knee,  134 
of  lingers,  127 

of  f(M)t,    I3() 

radial.  12O 
tibial,  134 
ulnar.  12') 
masses  of  atlas.  25 
of  ethmoid,  ')2,  (13 
of  sacrum,  21) 
jtortions  c)f  (Hcipit,!!  fionr,  40.  4., 
sacr(hi>c(  yge.il  liganii-nts,  11  \ 
surfaii'  <ii  railui^,  88,  H.j 
Latissimus  bur-.,i,  141) 
dorsi  muM  le.  140 

function-,  of.  147 
niTvi'  supply  of,  147 
Leg.  antcri'T  niuHile-.  of.  223 
extensor-,  of,  223 
fast  ue  1  il,  i^}, 
must  les  of.  211) 

tLtssiliiation,  235 
tiuter  mustles  tif.  222 
IM»steriur  niustlfs  of,  2n> 
LcT.-tT  c:irn-da  of  hytjiri  Inint-.  73 
multangular  (xine,  8<),  i>o 


Lesser  palatine  foramen,  40,  70 
pelvis,  130 

sacrosciatic  ligament.  I2(;,  130 
sciatic  foramen,  130 

notch.  1)6 
sigmt>itl  ntitth  tif  ulna,  87 
sui)raclavicular  ft)ssa,  171 
trochanter.  t)7 
tubercle  of  humerus,  85 
tubercular  ridge,  86 
wings  of  sphi-nt)i(!  Ixme,  47,  40 
Levator  ala'  nasi  mustle,  180 
anguli  oris  muscle,  181 
glandul.1'  thyreoitlea'  muscle,  173 
labii  ir.ferioris  muscle.  181 

superioris  ala'quc  nasi  muscle.  i.So 
mustle.  iSo 
menti  mustle.  181 
scapuKx*  mustle.  147 
functit)ns  t)f.  147 
nerve  supply  of,  147 
Levatores   costarum    breves   muscles, 
170 

Itmgi  mustles,  170 

muscles,  li-n) 
Ligamenta  mruscantia,  169 

Hava,  112 
Ligaments,  108 
accessory.  108 
acromitH  lavicular,  120 
alar,  1 15 
annular,  122 

anterior,  127,  221) 

internal,  231 

of  palm,  205 

[HKterior,  203.  208 
a|iical  iKlontoiil,  115 
arcuate,  128 

external,  156,  165 

internal,  165 

1H>pliteal,  135 
basal  dorsal,  127.  141 

intertis.seous,  127 

metatarsal,  interosseous,  141 

plantar,  141 

volar.  127 
bifuriate,  140 
caltaneiHulxiiil,  141 

plantar,  141 
ialcanet)libul.ir.  140 
lalcaneonaviiular,  141 

dorsil,  140 

plantar.  141 
I  .iltaneiiiibi.il.  131) 
1  ipilular.  ,in  ,  ,  lor.  "36 

|)Oslirii  r      (() 

transvcr>. ,    tf  ftKH,  1 3tj 
larpal,  126 

titjrsal,  203.  20S 

extci.s.ir    leniltm    sheaths     In- 
neath.  203 

railialf.  127 

transverse,  i  27.  20^ 
--lar.  208 
carpmielai  iirpal.  ttorsal,  127 

vtilar,  127 
check.  i=H 
Colles',  151) 


Ligaments,  conoiil,  120 
ctirattiacrtimial,  120 
coracoclavicular,  1 20 
ct)ract)humeral,  121 
costocIa\icular,  i  it) 
costotransverse,  anterior,  116 

miilille.  1 16 

posterittr.  1 16 

superitir,  116 
iDtyloitI,  131 
trucial,  134 

anterior,  134 

of  palm,  205 

posterior,  134 
cruciate,  1 15,  220 
crural,  transverse,  23^ 
cuboidet)navicular.  tltjrsal,  141 

plantar,  141 
cunetKuboiil,  tlt)rsal,  141 

intert>sseous,  141 

plantar,  141 
cuneometatarsal,  interosseous,  1  41 
deltoiti,  I  30 
dtjrsal,  t)f  ftK...  140 
Gimlx'rnat's.  131.  163,  1(14,  231 
glentiiil,  121 
hamatomelacarpal,  127 
iliofemoral,  132 
iliolumbar,  i2t> 
iliopettineal,  231 
inguinal,  131,  163 

rtfletHil,  151),  164 
interanitular,  110,  117 
intertarpal  iltirsal,  127 

vt>lar,  127 
inlercartilaginei.  i6<) 
inten  lavit  uiar,  111) 
interttjsial,  1 17 

external,  161) 

internal,  ifx) 
intert  uneiftirm,  dorsal,  141 

intertjsset)us,  141 

plantar,  141 
intert>sseous,  1 16 

basal,  127 

metalars;il.  i  \y 

cunetM"ulM)itl,  ■  •  1 

I  unettni,'talars.il.  141 

intercvmeiftirni,  141 

t)f  ft>ttt.  141 

sacroiliac.  12() 

taltnaltancal.  140 
intersi   ntuis.  1  1  • 
inltrtransvt  rsc,  •>{  vcrlebral  loluinr 

1 12 
isi  hiiH.ip-.ular,  132 
lat\ii,ite,  2.1,  231 
lat  un.ir,  131,  163.  164,  231 
lateral,  exit  rnal,  tif  arm,  I2J 
tif  head,  122 
of  knee.  13s 
'1,  i.iS 

lit     ar,  134,  I3S 

internal,  of  head,  122 
tif  knee,  134 

of  fingers,  127 

of  f'Jot,   I  ;:j 

radial,  122,  I2fi 


248 


INDEX. 


if 


Ligaments,  lateral,  tibial,  134 

ulnar,  122.  126 
lumlxKostal,  156 
navicular  tnneiform,  tlorsal,  141 

plantar,  141 
oblique,  123 

JHipliteal,  135 
«lontoi(l  apiral,  115 
of  ankle-joint.  130 
of  confluction,  loH 
of  costal  tubenle.  116 
of  external   malleolus,  anterior,  i,: 

posterior,  137 
of  fixation.  toS 
of  fiH)t,  137 

accessor)',  13Q 
of  hanil,  124 
of  head,  1 17 

inflependeni,  i  iS 
of  hyoiil  l«)ne,  1  jij 
of  lower  extrcmilies,  12S 
of  neck .  116 
of  pelvii  ginlle.  12S 
of  scapula,  i  20 
of  upper  eMreniities,  1  U) 
of  vertebral  column,  1 1 1 
orbicular,  1^2 
pal|iebral,  internal,  I7g 
patellar,  135 
pelvic,  128 

inilepenileni,  I2() 
pisohamale,  125 
pisometacarpal,  12; 
plantar  accessory,  i,^c) 

lonj;,  141 

of  fiHil.  140 

tarsal,  141 
]K)pliteal,  arcu.ite,  135 

oblique,  I  IS 
Poupart's,  lii.  if)? 
ptervRomaxillary,  184 
pteryg<)spinous,  i  if) 
pubi( .  inffrior,  12H 

s^pcior,  I  28 
pulxxap-ular.  132 
radial  lateral,  122,  126 
radiate,  11 0,  117 
raditwarpal,  dorsal,  126 

volar.  I  .''t 
reinforiinv;.  108 
rliomlKiid.  I  U) 
round,  i.;2.  13^ 
satrodKcy^eal.  ant*'rior,  113 

lateral.  1 1  ? 

posierioi,  I  n 
s.u  roiiiai ,  anterior,  I2<^ 

iniero>^n.us,  1  2t) 

|«i^Ierior.  121) 
sacrosi  iaiii ,  ^reat,  121) 

lesser     I  2(),    130 

sacrospi     us,  120.  130 
sacroiul-      'Us,  121) 
sjilienon      ilibular,  i  iH 
stellate,   ;    ^•.117 
■-tcrntK  iii\  11  ular,  1  ic) 
slvlohyoid,  I II) 

-IviolM.liidlbui.il,    I  I.N,    i.';4 

stylonuixillary,  184 


140 


•Vi 


Ligaments,  supraspinous,  112 
talocalcanea!,  anterior,  140 
external,  140 
internal,  140 
interosseous,  140 
]tosterior,  140 
talofibular,  anterio 

|M)steri<ir,  140 
talotibial,  anterior, 

jx>sterior,  130 
tarsal,  13Q 

d()rsal,  140 
tarsometatarsal,  dorsal,  14T 

plantar,  141 
lemiH)n')mandibuIar,  ;iS 
tibitmavicular,  I3(),  140 
*ransverse,  tapit'ilar,  127 
inferior,  121 
of  a:'.is,  1 14 
of  hip,  13T 
of  knee.  134 
.superior,  1 20 
tra|)ezoid,  120 
triangular,  150,  1O4 
ulnar,  lateral,  122,  126 
vaginal,  143 

of  foot,  23: 
\'  Jar,  accessory,  i  27 
Ligamentum  nuch.r,  113 

teres.  132 
Limbus  alveolaris,  ')8 
Linea  alba,  161,  1O3 
aspera,  1)7,  q8 
musi  ularis.  S3 
suprema,  40 
termin.dis,  2() 
Lingula.  48,  73 
Li(is,  glenoidal,  loS,  icx)    I2r 
of  hip,  131 
of  crest  of  ili'im,  1)4 
Lisfranc's  joint,  1 31) 

tutxTcle,  -^2 
Little  toe,  ball  of,  niusdes  of,  227 
l^iocking  mechanisms,  l)ony,  108, 
Long  lM>nes,  ig 

diaphyses  of,  n) 
epiphyses  of,  II) 
extremities  of,  K) 
neck  of,  20 
shaft  of.  1,, 
head  of  triceps  mus<  Ir-,  180 
must  les  of  bat  k.  14*) 

tlevclopmenl,  1  s'> 
plantar  ligament,  141 
|K>slerior  sat  roiliac  ligament,  1. 
Ltingissimus  tapitis  niustle,  150, 
terviiis  musile,  150.  151 
ilorsi  must  If,  1  10,  150 
musile,  141),  150 
funttions  of.  154 
nerve  supplv  of,  m 
LongilutHnal    ligaments    tif    verti 

t  oiumn,  1  1 1 
Ltingus  .itlanlis  niustle,  176 
( .ipiti>  ;  lusi  le,  176 
funttions  of,  17(1 
nerve  suppi>   of.  1  jf, 
ttilli  niustle,  176 


l.ral 


Longus    colli    muscle,    functions    of, 
176 
nerve  supply  t)f,  1 76 
L,>uis'  angle,  34 
Lower  extremity,  bursa-  of,  233 
fascia?  of,  231 
free,  skelettin  of,  t)7 
muscles  t)f,  2og 

classification,  235 
skeleton  tif,  82,  ()3 
jaw,  37.     Sec  also  Mandible. 
portion  t>f  longus  colli  muscle,   176 
Lumbar  jxirtion  of  diaphragm,   164, 

165 
rite,  28,  35 
triangle,  147 
vertebrae,  27 
LumlKKtistal  arch,  external,  165 
internal,  165 
'igament,  13b 
Lumlnxltirsal  fastia,  146,  156 
Lumbtjsacral  vertebra,  30,  36 
Lumbricales  bursx,  228 
muscles  t>f  ftHit,  210,  228 
of  hami,  200,  203 
functions  of,  203 
nerve  su|i|ily  of,  203 
Lunate  Ijtme,  8t),  tjo 


Maissiat's  baml,  232 
Malar  \nmv,  3b,  70.     Sec  also  Zygn- 
matic  hour. 
jHirlion  t)f  orbicularis  ,«  \ili  muscle, 

170 
surface  t)f  malar  ln)ne,  71 
Male  [k'vis,  131 

Malleolar  bursa,  subt  utanetjus  exter- 
nal, 234 
intern.d,  234 
surfates  c,f  lalus.  102 
Malleolus,  external,  101 

ligaments  of,  anterior,  137 
fMisterior,  137 
internal,  100 
Mammillar\'  pi<Kes.s,  28 
Mandible,  37,  71 
IkkK'  of,  71 
lM:rtlers  tif,  71 
developmeni,  73 
in  nt'w-lKirn,  73,  8t 
noil  h  of,  71 
prot  esses  tjf.  71 
ramus  of,  37.  71    72 
Manilibular  1  anal,  72 
foramen,  72 
fossa,   j8,  40,  S3,  1 18 
M.iniilirium  of  sternum,  34 
Marri  w.  iMine.  21 
Masseter  niusi  le,  iS> 
functions  ol,  i8^ 
nerve  sufifily  of,  183 
M.is-.eterii   iuliero>i'y,  72 
M.istoid  angle,  4,,  50 

Utnler  t>f  oi(i[)ital  lM>ne,  4ft 
tanaliiulus,  56,  5S 
tells,  S3 
fonlanelles,  8j 


INDEX. 


249 


Mastoid  foramen,  40,  43,  53,  54 
fossa,  54 

jKirtion  of  temporal  bone,  ,^8,  40,  52, 

53 
process,  38,  40,  5.?,  54 
Maxilla*,  37,  66 
Ixxly  of,  66 
developmem,  6q 
frontal  j)r(H-esses  of,  37 
in  ni'\vlK)rn,  6<),  81 
nasal  prcKi-sses  of,  37 
processes  of,  37,  66 
surfaces  of,  66 
Maxillary   cells,  63,  67 

process  of  inferior  turbinatexJ,  64 
sinus,  66 

orifice  of,  67 
surfa'e  o."  ])alate  Ixine,  tx) 
Meatus  acusticus  externus.  38 
auditorius  externus,  40 
nasopharyngeal,  77 
of  nose,  77 
common,  77 
inferior.  77 
middle,  64.  77 
suiwrior,  64,  77 
Medial  crus  of  diai)hraRm.  165 

inlertransversariuM  niustle,  15s 
Mi-dian  palatine  suture,  ^tj,  81 

plane,  1  7 
Me<lullary  cavity,  k) 
Membrane,  aUanHKx  i  i[>itai,  115 
(posterior,  1 15 
cosl(Koracoi(i,  170 
interosseous,  of  ra^lius  and  ulna,  ij  , 

of  tibia  and  fibi:la,  136,  137 
ol)tuiittor,  1 11;,  i2t) 
anterior,  1 15 
|K)Sterior,  1 15 
sternal,  117 
•-ynoviiit,  108 
tectorial,  111,  115 
Membrane. us  Ixjnes,  21,  22 
MtTiiscu^,  108 
of  knee  idint,  133 
funtti'-n  of.  136 
Mental  f<ii;unen,  37,  72 
protubt  \uue,  ' . 
si)ine,  "^2 
tulwrrlc    72 
Mentaiis  nuisi  le.  iSi 
Metiuarpal  lM)ne*^,  H2,  01 
base  of,  (ji 
lK)rders  of.  (>i 
development,  92 

llCild    111,  If.,  t)2 

shaft  of.  gi 
su»"faces  of,  gi 
MetacariM)pha!:inKial       artit  ulalitm^, 
127 

<tf  ihuml),  127 
Imr-^a-,  <ior-^al  sulu  (il;im*ous,  208 
Metaiarpus,  i»i 
Metatarsal  ljoni*s,  82,  105 

Ihisc  of,  105 

df'-r!'r|>men!,  106 

head  of,  10^ 


Metatarsi]  liones,  shaft  of,  105 

ligaments,  basal  intenwseous,  141 
Metatarsophalangeal        aliculation.s, 

137.  i.W 
Metatarsus.  105 
Nietopic  suture.  60.  62,  81 
Middle  articular   facet   of   calcaneus, 

of  talus,  103 

clinoid  pnnesses,  48 

costotransverse  ligament,  it6 

cranial  fossa,  41 

•Tura  of  diaphragm,  163 

cuneif(  rm  Inmes  of  f<ni|,  102.  104 

gluteal  line.  ()4 

ni  -alus  of  nose,  (.,    77 
j        ()lantar  eminence,     2^,  2Ti^ 
\       tur))inated  bone.  i(>3 
'    Monaniculiir  mu.si  U"^,  142 

Mucous  bursa',  1 43 
{        Nheath,  intertuben  ular,  121,  188 
I    Multangulai  •Mine,  greater,  .iij.  (jo 
I  lesser,  ik),  i;:> 

Mult'*ulus  cervicis  niustU,  152 

dorsi  must  le,  [52 

lundKirum  mii>t  le,  i  ^2 

must  le.  152 

function^  of,  ■  5  1 
nerve  supply  of.  :54 
Mu-'cles,   142 

alxlominal,  157 

antagonistii ,  14^ 

belly  of,  142 

li'articular.    42 

biceps.  142 

bipenniform,   i  \2 

bipinniile,  142 

bivrnter,  142 

cervical,  prevertebr.d,  176 

development,  1  ,s 

digastric,  142 

fusif<jrm,  142 

gluteal,  21 1 

head  of.  ^42 

hyoic  .  172 

infrahyoid,  172 

insertion  of.  142 

monarticular,  142 

nasal.  17).  1S2 

of  anterior  surface  of  thigh,  :i4 

(►f  back,  144 
tlat.  r45 
long.    40 
short.  154 

of  e.\tens«tr  surfii  e  of  fore:ir'n.  ms 
of  upper  ami,  iS<> 

of  face,  178 

of  fle.vor  surf.ice  tti  f»>re;irm,  l<)l 
of  upper  ;irni,  i  ^S 

of  fiMU.  224 

of  forearm,  185.  iiji 

of  hiind.  1^5,  U)S 

of  hfiid,  177 

of  hip,  210 

of  hyiM>then:ir  eminent  e,  200 

of  'eg,  310 

o.  it7-,vrr  r-'itremiti .  2Ci} 

of  niiistiiaiion.  182 


I    Muscles  of  ne(k,  171 
(tf  scalp,  178 
()f  shoulder,  185,  \Ah 
of  thenar  eminen<e,  kk) 
of  thigh.  214 
j        of  thoracic  walls,  Ki«) 
j        of  trunk,  144 

of  ujiper  arm,  185.  i,S8 
[  extremity.  185 

oral,  I  7-.J,  .So 

I        orb        ir,  1 42 

orig..of.  142 

alpebral,  170 

iiniform,  142 

j-innate,  142 

prevertebral  tcrvital,  176 
(juadriieps,  142 
I        short,  142 

sphincter.  142 
:        >pindle-shaped,  142 
supraiiyoid,  174 
synergistic.  143 
thoracic,  166 
!        triceps,  142 
lypital,  142 
Mus(  ulospiral  gro4»ve.  86 

nerve,  groove  for.  86 
Mux  ulotubar  <  anal.  5^,  5S 
Mylohyi-id  groove,  72 
line,  72 
r;    'he.  i  75 
Mylohyoideu-^  muscle,  174 
futK  lions  nf,  17:; 
ner\e  -ui>l)Iv  of,  175 

M,  ■;,,«>,  ,4.    • 

detinitio.i,  I  7 
general,  142 
spei  iai,  14.' 
Myonierlc  niu-dcN,  1S4,  185 


N.ARF.s.  anterior,  66,  76 

]>o-,terior,  3(> 
\a"«al  Uine-i,  37,  65 
development ,  65 
in  nt  \v-1mtii.  65 

iMinh  r  ot'   front*..  !?'«ne,  61 

I  an;ii,  75 

ravi.y,  7'. 

f  tramina  of,  77 

I  ttncha'.  37 

crest,  68,  (x) 

foramina,  65,  77 

must  les.  I  70,  1S2 

nott  h,  68 

IM)rti<»n  of  frontal  Uine,  60.  61 

proiess  of  maxilla,  37,  6ft.  67 

>eptim,  3;    76,  77 

•^pin« ,  anterior,  37,  68 
posterior,  v).  ^x) 

surface  tif  palatt  l«ine.  6«) 
of  s\iperior  i.iaxill,ir\ .  66.  fi7 
Nasalis  nui-;*  le,  r  S2 
Nasofrontal  suture.  37.  d^.  80 
NaMilai  hrvtnal  i  an;d,  64.  67,  7^ 
N  iM>fnaxiltarv  suture,  37,  6:^.  80 
N  Tsojihnryngcai  meatus.  77 
Nusoph 'r\ii\,  77 


250 


INDEX. 


Navicular  Ixmc  of  foot,  102,  103 
dcvdopmenl,  106 
of  hand,  8<),  90 
fibrocartilagf,  141 
Naviculari-cunciform  ligaments,  dor- 
sal, 141 
plantar,  141 
N'crk,  fascia-  of,  177 
ligaments  of,  116 
muscles  of,  171 
deep,  175 
short,  155 

development,  156 
of  femur,  97 
of  humerus,  anatomical,  85 

surgical,  H(i 
of  long  bones,  20 
of  radius,  88 
of  ribs,  ,^2 
of  scapula,  84 
of  talus,  102,  10^ 
Nerves  of  b<ines,  2 1 
Neurolog>,  definition,  17 
Nose,  meatus  of,  77 
common,  77 
inferior,  77 
laiddle,  64,  77 
superittr   64.  77 
"jchal  fascia,  15<> 
1,  e,  inferior,  41,  4f) 

superior,  41,  4(1 
surface  of  occipital  bone,  4ft 
Nutrient  canal  of  arm,  87,  81) 
of  tM>nes,  20 
of  radius,  87,  89 
foramen,  20 
of  tibia,  100 
of  ulna,  87 

Oblique  head   of   adductor   halluci^ 
muscle,  226 
ligament,  12,^ 
line  of  mandible,  72 

of  tibia,  too 
muscles,  164 
IHipliteal  ligaments,  I,VS 
Obliquus    aUlominis    exlemus    mus- 
cle, 157 
functions  of.  162 
nerve  supi)ly  of.  1A2 
internus  muscle.  IS",  't>o 
functions  of,  I'lj 
nerve  supply  of,  162 
capitis  inferior  muscle.  155 
functions  of.  155 
nerve  supply  of.  155 
superior  muscle.  155 
functions  of.  1 55 
nerve  supply  of.  ilj 
Obturator  i-xternus  muscle.  2011,  .'•ift, 

-'" 

functions  of.  .-iS 

nerve  sujiply  of.  21.H 
for.\nien,  0?.  o'l 
pr:..v..  o: 
intemus  musile.  20<),  21.5 

functions  of.  21,; 


Obturator  internus  muscle,  nerve  sup- 
ply of,  2 1 3 
membrane,  115,  129 

anterior,  1 1 5 

posterior,  115 
ridge,  95 
tubercle,  anterior,  05 

posterior,  95 
Occipital  angle  of  parietal  bone,  59 
bone,  38,  40,  45 

b:tsilar  jKirtion  of,  40,  45 

Ixirders  of,  4ft 

condyles  of,  45 

condyloid  portions  of,  45 

development  of,  47 

in  ne\v-lx)rn,  47,  81 

lamtxI'Mil  iKirder  of,  46 

lateral  [Hmioiis  of,  40,  45 

mastoid  border  of,  46 

nuchal  surface  of,  4 1 ,  46 

relations  of,  38,  40 

squamous  ixjrtion  of,  38,  45,  46 
border  of  parietal  bone,  59 
condyles,  40 
cest,  external,  46 

internal,  44,  46 
fontanelle,  81 
fossa,  inferior,  44,  46 

superior,  26 
protuberance,  external,  41.  46 

internal,  43,  46 
Occipitalis  muscle,  1 78 

functions  of,  178 

nerve  sufiply  of,  1 78 
Occipitomastoid  suture,  38,  40,  43,  53, 

TO 
Occiput,  articulation  of  first  and  sec- 
ond vertebra-  with,  113 
Odontoid  ligament,  apical,  1 15 

process,  25,  26 
Olecranal  bursa-,  208 
Olecranon,  87 

fossa,  87 
Olivary  eminence.  4t,  48 
Omohyoideus  muscle,  172,  173 
Opponens  digili    (|uinti   musele,    200, 
227 
funciii.n  of.  200.  227 
i\tT\e  supjtly  of.  200.  227 
V  muscle  of  fi»)t,  186,  210 
[M)llicis  muscle,  18A.  109 
functi(^n  of.  199 
nerve  supply  of,  199 
Optic  foramen.  41,  48,  75 

gro<)ve,  41.  48 
Oral  cavity,  riMif  of.  78 

muscles.  179,  180 
Orbicular  ligament.  132 

muscles,  142 
Orbicularis  oculi  muscle,  179 
functions  of,  i.So 
tierve  supj)ly  of.  180 
oris  muscle.  180,  181 
Orbit,  margins  of.  7^ 
walls  of,  73.  74 

de^'i'loprncnl .    ':fl 

Orbital  lavil'.es.  37.  73 
cri-sl  of  -phenoidal  Ixinc,  50 


Orbital   fissure,  inferior,   37,   39,   66, 
7'.  74,  7,i 
superior,  37,  42,  49,  74.  7.'i 
pLites,  61 

surfaces  of,  61 
portion  of  orbicularis  muli  muscle, 

I7Q 

process  of  palate  bone,  70 

surface  of  lachrymal  l>one,  65 
of  malar  bone.  71 
of  orbital  plates,  6 1 
of  sphenoid  lione,  49,  go 
of  superior  maxillary,  W) 

wings  of  sphenoid  bone.  47.  49 
Orifice  of  aquaductus  cochlea',  56 

of  canaliculus  cochlea-.  56 

of  maxillary  sinus,  67 
Origin  of  muscle,  142 
Os  basilare,  47,  51 

capitatum,  8g,  90 

inca;,  47 

incisivum,  69 

interparietale,  47 

magnum,  8g,  90 

nasoturbinale,  64 

planum.  63 

trigonum.  103 
Ossa  Bcrtini,  48 

suturarum,  83 
Ossification,  21 

centers,  21 
Osteology,  19 

definition,  17 

general,  19 

special,  22 
Outer  crura  of  diaphragm,  165 

head  of  gastrocnemius  muscle,  220 
of  triceps  muscle,  190 

leg  muscles,  222 

lip  of  '.inea  aspt-ra,  97,  98 

|Kirtion  of  longus  colli  muscle,  176 

vitreous  table  of  flat  Imnes,  19 
Outgrowths,  20 
Oval  fossa,  232 


P.\CCHIONIAN  depressions,  44,  60 
Palate  bone.  611 

development,  70 
horizontal  plates  of.  (tq 
in  newborn,  70 
perpendicul.tr  [)late  of.  6<) 
processes  of.  70 
surfaces  of.  U) 
hanl,  39,  68,  78 
in  newlKirn.  68 
tuberosit\'  of.  40 
Palatine  ( anals,  fn) 
cells,  63,  70 
foramen,  greater,  40,  (x) 

lesser,  40,  70 
gr(K>ves,  68 
prftcess,  31),  66,  68 
sjiines,  68 

suture,  metlian,  39,  81 

transverse.  39.  81 

PalatiK'thmotdal  suture,  80 

Palatomaxillary  suture,  80 


INDEX. 


251 


Palm,  tendons  of,  205 

flexor,  205 
Palmar  a[)oneurosis,  ii)8,  207,  208 
Palmaris  brcvis  muscle,  186,  ig8 
function  of,  i(^ 
nerve  supply  of,  I'W 
longus  muscle,  185,  i()i 
function  of,  igi 
nerve  supply  *)f,  IQI 
Palpebral  ligament,  internal,  171; 
muscles,  I7g 
jjortion  of  orbicularis  oculi  muscle, 

rqphc,  external,  171) 
Par-glenoidal  groove,  ()5 
Parietal  angle,  50 
bo.ic,  ^(1,  5() 
angles  of,  5g 
borders  of,  5q 
development  of,  50,  60 
in  new-Uirn,  60 
sulci  of,  5(> 
surfaces  of,  59 
bor^   r  of  frontal  bone,  60 

emporal  bone,  52 
cn.i  ence,  59 
foramen,  44,  50 
notch,  52 

surface  of  parietal  fxine,  50 
Parietomastoid  suture,  38,  j.v  7<) 
Parotidcomasseteric  fasda,  184 
Patella,  09 
aiH'X  of,  Ql) 
base  of,  gg 
development,  gg 
surfaces  of,  gg 
Patellar  ligament,  1,15 

retinaculum,  external,  135 

internal,  135 
surface  of  femur,  g8 
synovial  fold,  135 
Pectineal  bursa,  234 
fascia,  232 
line,  g8 
Pectineus  muscle,  20<),  216 
function  of,  2if> 
nerve  supply  of,  216 
I'ectoral  fascia,  170 
Pectoralis  major  muscle,  166 
functions  of,  1(17 
nerve  supply  of,  167 
minor  muscle,  if)(),  if)8 
functions  of,  168 
nerve  supply  of,  i68 
Pellicles  of  vertel)ra',  2\ 
Pelvic  contraction,  plane  of,  130 
diarthroses,  1 2S 
expar  ion,  plane  of,  130 
ginlK    ,)3 

articulations  of,  128 
ligaments  of,  1 28 
inlet,  130 
ligaments,  12S 

independent,  i  2g 
oulli'l,  131 
svnarthrosLcs,   128 
Pelvis,  128,  130 
a|)erture  of,  inferior.  131 


Pelvis,  a[)erlure  oi,  superior,  130 
bony,  g3 
cavity  of,  1 30 
diameters  of,  131 
false,  130 
female,  131 
greater,  130 
lesser,  130 
ligaments  <if,  1 2g 
male,  131 
true,  130 
Penniftjrni  musdes.  142 
Perichondrium,  21 
Periosteum,  21 

Perona'us  hrevis  muscle,  210,  223 
functions  of.  2  2^^ 
nerve  supply  of,  223 
longus  muscle,  210,  222 
function  of,  222 
nerve  supply  of.  222 
sheath  of,  231 
tertius  muscle,  210,  224 
function  of,  224 
nerve  supply  of.  224 
Peroneal  gnxtve,  103,  104 


process,  103 
retinaculum,  inferior. 


'.^o 


superior,  230 
PoriK-ndicular  plate  of  ethmoid  Ixme, 
62,  63 
of  palate  Ixmc,  (») 
Pes  anserinus,  214.  216 
Pctit's  triangle.  147 
Petrooccipital  fissure,  40.  43,  54,  81 

synchondrosis,  81,  1 18 
Petrosal   Ixirder  of  sphenoidal   Ixmc 

50 
fossa,  1,6 

gRMive,  inferior.  43,  45,  55 
superior,  43.  55 
Petros<|uainosai  I'lssure,  53,  54 

suture,  81 
Petrotympanic  fissure,  53,  57 
Petrous  jKirtion  of  tcin(K)ral  bone,  40, 
52.  54 
apex  of,  55 
Phalanges  of  fiMit,  82.  105 
development,  loO 
of  hand,  82,  <)2 

articular  lapsuK's  of,  127 
articul.itions  of,  127 
Ixiniers  of.  02 
developmenl,  ()2 
movements  of.  127 
shaft  of,  02 
surfaces  of,  g2 
troihlea  of,  g2 
ungual,  02 
Pharyngeal  canal,  411,  51 

lulK-rcle,  45 
Pill.ir  of  sulxulaneous  inguinal  ring, 
anterior,  150 
inferior,  158 
posterior.  150 
superior,  |i;8 
Pinnate  muM  les,  142 
Pintorni  bursa,  234 
Piriformis  muscle,  20<),  212 


Piriformis  muscle,  function  of,  213 

nerve  supply  of.  213 
Pisifcirm  lM)ne,  .Scj.  c)o 

articulation  of.  124.  125 
Pisohamate  ligament,  125 
Pisc)meiacar|)ai  ligament,  123 
Pituitary  Ixicly,  48 
I*ivot  joint,  ICH) 
Plane  of  pelvic  contraction,  i  ^o 

expansion,  130 
Plantar  basal  liganients.  141 
lalcaneoculiiiid  ligament,  141 
calcaneonavicular  ligament.  141 
c*  *ioiclectna\ic  uiar  ligament,  141 

lecK'ulMticI  ligament,  141 
t.    'nence.  external,  2^^t, 
;ernal,  233 
iniddle,  225.  233 
intercuneiform  ligaments.  141 
interossei  muscles,  227.  228 
ligament,  accessory.  131) 
long.  141 
of  fcKit,  140 
naviculari^  unciform  ligaments,  141 
surfac-e,  18 
tarsal  ligaments.  141 
tarsometatarsal  ligaments,  141 
Planlaris  muscle,  220 
Planum  nuchale,  41,  41/ 
cK'ci|)itale.  41,  46 
.sternale.  34 

temporale,  38.  50.  52,  ,>i).  60 
Matysma  muse  le,  1  71 
functions  c:f.  1  71 
nerve  supply  of,  171 
Pneumatic  Umes,  k) 
Polyaxial  joints,  1 10 
Po[ili.,al  bursa.  136,  221,  234 
ligament,  arc  uate,  135 

obliciue,  135 
line,  100 
space.  c)8 
Popliteus  muscle,  210,  21c),  220 
funclion  of,  221 
nerve  supply  of,  221 
Porus  ac  usticus  inlernus.  43 
Positions,  designations  of,  17,  18 
Postaxial  muse  Ic-s  of  lower  extremity 

2.<s 

of  upper  extremily,  20c) 

Posterior  alKlominal  muscle.  it)2 

developtnent,  rt)4 

annular  lig.inicnt,  20^,  20.S 

arch  of  vertebra.  22 

articular  facet  of  ealiaiicu-.  10 ; 

of  lain-,  102 
atlanlo-oeeipilal  membrane-.  115 
l«'lly  of  elig.ustrieus  nuisc  Ic.  174 
bursa  of  ghiueus  ine<iiu>,  212 
capimlar  ligame-nt,  1  1'' 
e  iinoid  processes,  4-8 
conclvloiei  e  ,in;ii.  40 

process  of  manelible.  72 
lostotransverse  ligameni,  11') 
cranial  fewsa,  41,  43 
crucial  ligament.  134 
crus  ol  sui)cutaneous  inguinal  ring, 

l.SO 


■^A^-;**!ifc\filr\" 


n 


252 

Posterior  ethmoidal  foramen,  'ii,  75 
fontanellc,  81  ' 

("luteal  line,  Q4 
inferior  spine  of  ilium,  q4 
inlerconilyloid  fossa,  qq 
intermuscular  septum,  2.?,? 
intenxeipital  synehonilrosis,  47 
intertransversarius  muscle,  15s 
inlraocrijiilal  synchondrosis,  ,Si 
huhrymal  i  rest,  (15 
layer  of  lumlxKlorsal  fascia,  i.s() 
ligament  of  external  mallei>lus,  1,^7 
lonRituilinal    lipiment    of   verteliTn 

(olumn,  II I 
muscles  of  thigh,  218 
nares,  30  | 

nasal  spine,  .w,  60  I 

obturator  memlirane,  115  j 

tubercle,  05  ■ 

pelvic  surface,  <|(> 
pillar  of  subcutane<ius  inguinal  rinj;, 

jKirtioii     of     cjuaclratus     lumburuni 

muscle,  162 
jiriHCss  of  talus,  102  j 

sacral  foramina.  2() 
sacrococ  (  ygeal  lisaments,  113 
sarroiliac'lii^ament,  129 
surfaie  of  tibul.i,  loi 

of  humerus,  .S(> 

of  legs,  muscles  of,  211) 

of  tiVna,  100 

of  ulna,  87 

of  zvprniatir  Ixme.  ;i 
taloiaicaneal  ligament,  140 
talolibular  ligament,  140 
talotibial  ligament,  i.V) 
trochant.Tic  bursa  of    gluta-us  me- 

diu-,.  .'I  2.  2,u 
Pouparl'-  ligament,  1,^1,  if'.i 
Preaxial   muscles  of  lower   extremity, 

of  upper  extremity,  20<) 
Prepatellar  bursa,  subcutaneous,  136, 

subfascial,  i^h 
subtenilinous.  136 
Prevertebral  c  ervical  muscles,  i  76 


fascia,  177 


—S 


rriHcnis  nasi  muse  le, 
Proces'-c's,  20 
accessory,  28 
at  romion,  84 
nlar,  (1? 

alveolar,  37.  ''''•  '^^ 
articular,  20 

of  vertebra-,  23 
c'.inoid,  anterior,  41,  4<) 
middle,  48 
posterior,  48 
rondyloid.  20,  38,  71,  72,  7? 
coracoid,  84 

Kironoid,  of  m.indibli',  ,?8,  71,  73 
anterior,  72 
..i  uina.  '-7 
costal,  24  ,  .  , 

ethmoidal,    of    inferior    lurbmaled, 

64 


IN HEX. 

Processes,  external  angular,  3O  ! 

of  calca     us,  103 

of  talus,  102 
falciform,  12() 

frontal,  of  maxilla,  37,  fi6,  <'7 
frontosjjhenoidal,  37,  71 
hamular,  4°,  S''  '1° 
inferior,  of  temporal  bone,  ^J 
internal,  of  calcaneus,  103 
intrajugular,  46,  55 
iugular,  43,  4b  ,  .  , 

lachrvmal,  of    inferior    turbinated, 

mammillary,  28 

mastoid,  38,  40,  53,  54  . 

maxillarv,    of    inferior    turbinated, 

f)4 

n.asal,  of  maxilla,   ,7,  W),  f)7 

cKlontoid,  25,  2() 

of  sacrum,  sui>erior  articular,  2C) 

of  vertebra-,  23 

orbital,  70 

jialatine,  30,  6(>,  68 

peroneal,  103 

posterior,  of  talus,  !C2 

]ilerygoici,  3(1,  47-  5° 

|iterygospinous,  51 

]iyramidal,  40 

of  palate  bone,  70 
sphenoi'l,il.  of  palate  bone,  70 
s]iinous,  of  tibia,  i)c) 

of  vt-telira',  23 
styloid,  c)f  metacariial  lion,',  0' 
'of  radius,  8(i 
of  tem|ioral  bone,  40,  ,S') 
of  ulna,  88 
supracond  vliiid,  87 
tcTOporal,  of  ulnar  Ume,  71 
transverse,  of  vertebre,  23 
troi  hlcar,  of  calcaneus,  103 
un<  iform,  tyo 
uncinate,  (14 
vaginal,  of  jiterygoid  processes.  4<), 

51 

of  temporal  Ixme.  5'',  57 

xiphoid.  34 

foramen  of,  3'> 
zygomatic,  of  frontal  li 
'  of  maxilla.  M.  67 
of  temjioral  bime,  3ft,  3S,  30,  S2 
Processus  civinini,  51 
costarius,  24 
mastoideus,  40 
pvramidalis.  40 
Promontory,  groove  of,  58 
of  vcrti  bral  ccilumn,  ,]o 
Prcmation,  12  ( 

Pronator  ciuadratus  nuisde,  185,  I<J4 
function  of,  n)t 
nerve  supply  cif.  i')4 

ITS  muscle,    185,    IC(I 

j  function  of.  i')i 

ncTve  sujiply  of,  loi 
Protuberance,  mental.  71 
Prc'ximal  r.idionlnar  articulation.  122 
I'^cias  major  muse  le,  210 
minor  must  le,  210,  211 
Pterygoiil  ctmtd,  50,  78 


.  60 


Pterygoid  depression,  73 
fo,s.sa.  40,  51 
notch,  51 
plate,    xternal.  40,  5° 

internal,  40.  ;3 
process,  3C1,  47   50 
tul)erosity,  72 
Pterygoidei  mu^   les,  182,  183 
functitins  ol,  184 
nerve  supply  of,  184 
Ptervgoideus  externus  muscle,  183 

internus  muscle,  183 
I'lervgomtimlibular  r.iphe,  182,  1S4 
I'ter'vgomaxillary  ligament,  184 
Pterygopalatine  canal,  ji,  (*) 
fossa,  50,  78 
groove,  51,  67.  'x) 
Ptervgospinous  ligament,  1 19 

process,  51 
Pubic  angle,  131 
arch,  131 

ligaments,  inferior,  128 
superior,  128 
Pubis,  c)3,  05 
ilevelopment,  cjf) 
ramus  of,  c;;,  0'' 
Pul>ocapsular  ligament,  132 
Pulleys,  143 
I'ulmcmarv  groove,  35 
Pulpy  nut  leus  tif  intervertebral  fibro 

cartilage-,  1 10 
PvramicI  of  temporal  bone,  52,  54 
apex  of.  5S 
i    Pvramitlal  emiiunce.  57 

'prticess  t)f  ptilate  iKine,  40,  70 
Pvramiilalis  muscle,  1(11 
i      '      funclicms  of.  ih2 

nerve  sujiply  of,  162 
n.a.si  muscle,  178 


QCAUKATUS  femoris  muscle,  20c),  213 
function  of,  213 
nerve  supply  of,  213 
labii  inferioris  muscle,  181 

superioris  muscle,  180 
lumborum  muscle,  162 
functions  of,  ih? 
nerve  supply  of,  i'>3 
]>lanta' muscle,  210,  225 
functitm  of,  225 
nerve  sui)ply  of,  225 
Qutidritep^  femoris  muscle,  20c),  214 
function  of,  21:; 
nerve  suppiv  of,  215 
muscle,  142 
Qjaclrilateral  foramen,  r6f> 


R,\DI.\L  carpal  eminc-nc",  i)o 
fossa,  87 
he.ad  of    flextir   digitorum 

-.ttuscle,  ic)2 
lateral  ligament,  122,  I2(> 
mu^t  Ic-s  of  forearm,  ic)4 
lit  1  ^c-,  gloo\c  fi.: ,  .-'O 
notch  of  ulna,  87 

Radiate  carpal  ligament.  127 


lublimis 


i6i 


Radiate  liganirnts,  Ii6,  n" 
Railiorarpal  artiiulaliims,  124 
ligament,  dorsal,  12I' 
volar,  I2h 
Radioulnar  artii  ulalion,  distal,  w^ 

proximal,  i.'2 
Radius,  H2,  SS 

and  ulna,  relations.  Si) 
articular  rinumferenie  of,  88 
borilcrs  of,  88 
development,  S() 
extremities  of.  88 
hea.l  of,  88 

inteross'-ous  ri(ls<'  "'.  "" 
ner  i  of,  88 
nutrient  canal  of,  81) 
shaft  c',  88 
si-rfac-'S  of,  88 
tuberosity  of   88 
Ra.-iX  arcus  vertebra-.  23 
R;  nus  of  isdiium,  ()4 
of  mandible,  .^7,  71.7^ 
of  pubis,  1).?,  ')$■  ')'! 
Rectus  alj<lomiriis  muscle 
development,  1^4 
func*.it>ns  of,  i'>2 
nerve  supply  of,  162 
capitis  anterior  major  muscle,  17 
minor  muscle,  177 
functions  of,  177 
nerve  supi)ly  of,  177 
lateralis  muscle,  155 
functions  .'f.  I55 
nerve  supply  of.  '55 
posterior  major  r-.uscle,  155 
ere  ;  '       47 
fun(  ti     s  .if,  155 
nerve  supply  of,  155 
minor  muscle,  155 
functions  of,  155 
nerve  sujiply  of,  .5.S 
femoris  muscle,  214 
muscles,  if)4 

external,  spine  for,  76 
Red  boiu'-marrow,  21 
Rellected  iiiKuinal  ligament,  I5r), 
ReirforcinK  liK.imeiils,  108 
Retinacula  perona'orum,  :'22,  230 
Reti.iaculum  of  arc  uatc'  lij;ament, 
patellar,  external,  ;.^5 

internal,  i  ?5 
peroneal,  inferior,  2,?o 

superior,  230 
tendon,  142,  14  i 
Ri'lralien*  auricula-  muscle,  171) 
Rliachischi'-is,  j(i 
RnomlMiid  li|;anunl,  1  i<) 
Rhomboideus  major  muscle.  147 
func  tions  of.  1  17 
nerve  supply  "f.  '  17 
minor  nuisiles.  1  17 
functions  of,  1  17 
nerve  supply  ol,  147 
Ribs,  22.  ,v 
alxlominal,  28 
.:^nc;!e  of.   12 
artlculatic'ms  oi,  with  sternum, 

H7 


I'M 


INDEX. 

Ribs,  articulations  of,  with  vertebral 
column,  2b,  116,    117 
IhxIv  of,  ,v 
bony,  32,  .^,5 
cervical,  35 
curvature  of,  v? 
development  of,  ,^5 
eleventh,  3.5 
false,  33 

fenestration  of,  3'> 
first,  32 
lloating,  33 
head  of,  32 
lenKth  cjf,  ,^,^ 
lumbar,  28,  35 
movements  of,  117 
neck  of,  32 
sacral,  3'> 
second,  ^^ 

surface  c  urvature  of,  33 
torsion  c  urvature  of,  ^^J, 
true,  33 
twelfth,  33 
tvpical.  32.  33 
Ririn,  alxlominal,  external,  15S 
inguinal,  subc -ataneous,  158 
Ridge.  bici|>ilal,  8() 

interosseous,  of  fibula,  101 
I  of  radius,  88 

I  of  tibia,  100 

1  of  ulna,  87 

\        intertrochanteric,  c)7 
'        obturator,  ci; 

sphe.iomaxillary.  50 
■        supinator,  87 
temporal,  ^8 
I        tubercular,  greater,  86 
les-cr    So 
Risorius  nuisc'e,  180 
Rcof  of  oral  cavity,  7S 
RcK)t  of  MTUbra-.  23 
Rostrum,  sphenoidal,  4^.  4') 
Rotary  vertebra-.  23 
Rc.tatoresbrevc-smu-.cle>,  152,  153 
longi  iiUiscU-!,  152,  153 
iuuscli,-s,  r;2,  153 
functions  of.    154 
nerve  sujiply  c>f,  1  >t 
Round  ligaiiunt,  132.  i3.( 


i.VS 


'    S.^crl'l  AR  recess,  122,  123 
Sacral  can.il,  2c> 
cornu.  2ij 
foramina.  28.  21) 
inti-rvcrtcl>ral,  2c) 
J        hiatus,  j(|,  31 
rib.  3'> 

tuberosiiv.  21) 
Sacroc.iicygeal  ligament,  anterior, 
lateral,  1 13 
posterior,  1 13 
svmphvsi-,  1 13 
Sacroiliac  arlic  ilation.  128 
ligament,  ai  lerior.  121) 
interos..cous,  1  --i) 
,i(-,,  p.ci.ri.ir,  12:; 

Sacrosciatic   foran      ,,  130 


-'53 

Sacrosciatic  liganvnl.  greater,  1  21) 

leaser,  1  2cj,  130 
Sacrospinalis  muscle,  i4c| 
'line  tions  of,  15  J 
nerve  supply  of,  I54 
Sacrospinous  ligament,  I2ci,  130 
Sacroluberous  ligament,  12c) 
Sac  rum,  28 
a[)ex  of,  2A,  50 
ba.se  of,  28 
canal  of,  21) 
crests  of,  2c) 
development  of,  31 
dorsal  surface  of,  2c; 
female,  30 
foramina  of,  28,  2C) 
intervertebral,  2e) 
joints  of,  1  1  i 
male,  30 

movements  of,  1 1 3 
pelvic-  surface  of,  28 
prcM-esse-^  of,  Nupcrior  articular,  2 
lulM-rosity  cif,  21J 
upper  surface  of,  21) 
Saddle  joint    1 10 

Sagitt:il  Imrdi-r  of  |iaric-tal  iMinc,  ,Vi 
gro.,v   .  4),  4''.  '».  '" 
plane-,  17 
suture,  71) 
Saphenous  opening  of  f.iscia  lata,  23  j 

vein,  great,  2},2 
Sartorial  bursa,  214 
Sarlorius  muscle.  201),  21  1 
function  of,  214 
nerve  supply  of.  214 
Scalene  tubercle,  32 
Scaleni  muse  les.  i  75 
functions  lel,  1  "') 
nerve  supplv  ol,  1  7'> 
Si  alenus  anterior  mu-'  le,  175 
mc-dius  muse  le,  175 
minimus  muse  le,  i  70 
posterior  muse  le-,  1  75 
Scahi,  muscles  of.  178 
Scaiihoiil  bone- of  foot,  102,  103 
dc'vc-lopmc-nt,  io() 
of  hand,  .So,  c)o 
fossa,  51 
Scapula.  83 

angles  of.  .S3.  84 
base-  .if.  83 
border- of,  83,  S4 
de^elopme-nl,  84 
head  of,  84 
ligaments  of,  120 
margin-^  of,  83 
neck  of.  S, 
-pine  of.  Si,  84 
surf.iees  of,  83 
Scapuleir  iioti  h.  84 
Siarua's  fa-cia,  1I13 
Sciali.   bursa  of  gUila-iis  maximus,  2\\ 
foranic-n,  great.  1  \o 

le-sser,  130 
notch,  gre-at,  Ol.  0" 

li-sse-r.  1)0 

Si.re.nil  .  ime-iform  bone-,  104 
Sella  tunica,  ti-  17-  4-'^ 


254 


-8 


i\     •■'■  ;  --  ». 

t...      ■■-,     ■■>. 


Semiranal  for  Eustachian  tub 

for  tensor  tympani,  58 
Sc-miririular  lini-,  if)i 
Seniilun^ir  bono,  Sy,  yo 
cartilaps,  I.V3 

funition  of,  136 
lini',  i(K) 

note  h  of  ulnar,  87 
surfaii-  of  aictabulum,  qd 
Seminu-mbranous  bursa,  136,  210,  2^4 
musili'.  2CK),  2 1 8,  2iy 
funi'ion  of,  2i<) 
niTVf  su|>]ily  of,  211) 
Scmispinalis  capitis  musrlo,  151,  152 
rcrvicis  musilc,  152 
(lorsi  musi  li-,  152 
muscles,  152 

functions  ol.  154 
nerve  supply  of.  154 
Scmitenilinosus  musde,  20Q,  218 
(unction  of.  21c) 
nerve  supply  of,  210 
Septum  ■hoanaruni.  39,  bb 
inlermusiular,  143 
anterior,  of  lej;,  233 
external,  of  arm,  207 

of  tlii»;l>.  232 
internal,  of  arm,  iSS,  207 

of  thigh.  21,2 
of  arm.  iSS,  207 
of  IcK,  233 
of  thi«h,  232 
posterior,  of  Icr,  233 
nasal,  37'  7^'*  "7 
Serrate  suture.  ro7 
Serratus  anterior  muscle.  ''lO,  if)8 
function-  of,  i(k) 
nerve  sui'ply  "f.  ''"> 
magnus  mu-t  Ic.  i()8 
functions  o(,  itx) 
nerve  supply  of,  ifx) 
[Kisterior  inferior  musiK.  148,  171 
fund  ions  of,  14^ 
nerve  -upply  of,  14S 
superior  mu-i  le,  148,  171 
functions  of,  14** 
nerve  supply  of,  148 
Sesamoi<l  Ijones,  143 
of  fiKit.  82.  loO 
of  hand.  82,  (12 
Sheath,  intertubtnular  mucous,    121, 
iSS 
perc.iueus  lonKus,  231 
re    us  alnlomini-.  I'li 
synovial,  of  dors.il  <ar]ial  ligament 
203 
.if  fmgers.  2C5 
of  llcxor  lendons  of  p.ilm,  205 

of  fool,    2  2.) 

Short  Ikmus.  i.) 

extern.iUalcral  ligament  of  knee,  13: 
muscles.  ]42 
of  back,  154 

<!ivelopnu-nl,  156 
of  neck.  155 

development,  156 
posterior  sacroiliac  ligament,  i2c) 
Shoulder,  articulations  of,  121 


INDEX. 

Shoulder  ginile,  83 
muscles  of,  185,  186 
classification,  20Q 
Shoulder-blade,  83.     Sec  also  Scapula. 
Shoulder-joint,  121 

movements  of,  121 
Sigmoid  groove,  43,  4''.  53.  *'° 
notch  of  mandible,  38,  71 
of  radius,  8() 
of  uln.i.  greater,  87 
lesser,  87 
Simple  joint,  io<) 
Sinus,  frontal,  61 

development,  62 
maxillary,  66 

(trifice  of,  67 
of  tarsus,  102,  103 
sphenoidal,  47 
Skeleton,  ai-pcnclicular,  22 
axial,  22 
divisions  of,  22 
of  extremities,  22.  82 
of  foot,  loi,  106 
of  free  lower  extremity,  q- 

upper  extremity,  83 
of  hand,  02 
of  head,  22,  36 
of  lower  extremities,  82,  03 
of  trunk,  22 

v;Lriations  if,  .'.i 
of  uiMier  evtren.nies,  82,  83 

Skull,  36 

anterior  aspect  of.  36 

l)ase  of.  external  surface  of,  3c) 

internal  surface  of,  41 
iKmes  of.  44 

developmental  cla.ssification   44 
disarticulated.  36 
external  surface  of  base  of,  3<) 
inner  aspect  cif,  44 
lateral  aspc'it  of,  37 
of  newlKirn,  81 
-uperio;  aspect  of,  44 
-utures  of,  7c) 
Smiling  musdi .  iSo 
Sockets  for  teeth,  68 
Sole  of  foot,  muse  lis  of,  225 
Solcus.  arch  of.  220 
muscle.  2i().  220 
Special  anatomy,  definilion,  17 
Sphenoethmoidal  recess,  77 

suture,  7c) 
Sphenofronlal  suture,  37.  4I>  4').  7') 
Sphenoid  bone,  37,  y),  47 
body  of.  47 
iMirdcrs  of,  4c).  '50 
ciTcbral  juga  of,  50 

surface  o',  42 
development  of.  s;! 
digitate  imprc'ssions  of,  50 
greater  wing  of.  42 
in  newborn.  51.  81 
lesser  wings    f,  41 
orbital  c  rest  of,  50 
v.iii.cllon-  in,  31 
wings  of.  greater,  47,  49 
surfaces  of.  4c) 
lesser,  47,  4<» 


Sphenoid  bone,  wings  of,  orbital,  47, 

4') 

tem]K)ral,  47,  41) 
spine  of,  3c) 
Sphenoidal  angle,  36,  59 
cells,  63 
crest,  48 

fissure,  37,  42.  49.  74.  75 
fontanelles,  82 
process  of  palat^  bone,  70 
rostrum,  48,  41/ 
sinus,  47 
spine,  56 

turbinated  Imnes.  48 
Sphenomandibular  ligament, 
I   Sphenomaxillary     '  .sure,  37, 

74.  75 
I        fossa,  41),  50,  78 
1        ridge,  50 

I       surface  of  sphenoidal  bone,  50 
j       suture.  Si 
1   Sphenooccipital  fissure,  45 

svnchondrosis,  41,  45,  47,  81 
Sphenoorbilal  sutu'c,  ■;<) 
Sphenofialatine  foramen, 
notch. 


118 
,39, 


,78 


nolcn,  70 
Sphenoiiarietal  suture,  37,  38, 4',  7c),  82 
Sphenopetrosal  fissure,  3g,  4°.  4^-  54. 

synchondrosis,  81,  it8 
Splicnosciuamosal  suture,  38,  39,  4-'. 

4^,  52,  .80 
Spheno/.ygomatic  suturc\  77,  38,  50,  80 
Sph;'rciici  joints,  no 
Sphincter  muscles,  142 

oris  muse  le.  181 
Spigelius'  line.  160 
Spina  ree  ti  lateralis,  50 
Spinal  canal,  31  ,      ,      , 

column.  22.     See  also  Vrrlchral  mi- 
ll 111 11. 
Spinalis  eapilis  muscle,  151,  15- 
cervicis  muse  te,  151 
de.rsi  muscle,  151 
muscles.  14C1,  151 
functions  '>f.  154 
nerve  supply  of.  154 
Spindle-shaped  muscles,  142 
S]iine,  20 

anterior  nasal.  37 
ethmoiihd.  41-  4^ 
for  external  rectus  muscle,  76 
frontal,  61 
mental,  72 
nasal  anterior,  68 
1  po-icrior,  6<) 

j        of  ilium,  anterior  inferior,  94 
superior.  ei4 
IMisterior  inferior,  94 
of  ischium.  ■/6 
'       of  jiubis.  ey5 

of  scapula.  83,  84 
palatine.  68 
sjihenoidal,  56 
v.ipramealal,  5' 
trochlear,  61 
tympanic,  greater,  57 
lesser,  57 


INDEX. 


Spill"! ransvcrsali^  muMle,     v 
Spincius  jiriKi-ss  oi  tibia,  i)i) 

<if  viTtebnu,  2,; 
Spiral  joint,  ico 
SplanrbniiluKy,  (ii'l'iiiiliDn,  17 
SpU-nius  lapiiis  nuis(  k-.  14** 
fumtiiin'^  nf,  U'** 
nerve  supply  "f>  14!^ 
lerviiis  muMle.  14** 
funitions  (if.  I  l^^ 
nerve  ^upplv  nf.  14?* 
Squum.isal  Inmler  .if  parietal  Imne,  50 
uf  sjibenciiii  limie,  50 
suture,   ^S,  ),?.  s-'.  T'l 
Simaniii-.imastoi.l  suture,  5.t,  5.1M 
S.iuam.iu^  purli.ins  uf  .i.ripual   bune, 

.V**.  -t.v  4'' 
of  temporal  txine.  .?■"*.  4°,  4.i,  .s- 

>ulure.  107 
Slellate  liijaments,  1 1(>,  117 
Sternal  eMri'iiiity  of  el.ivii  le,  >**5 
menilirane.  1 17 
jiortion  of  iliapliraKni,  I'M 
synchonilrosi'-.  1  17 
Sternalis  muM  le,  I'V 
Sternoi  l.ivieular  artieulation,  no 

ligament,  "') 
Slern.K  leiil.         '.oideus  inusele,  1 :  i 
funitions  of.  17-' 
nerve  supply  of.  17-' 
Stcrnoeostal  artieulations,  117 

portion  of  peetoialis  major  imiM  le 

■'17 
Sternobyoi.leus  mu-i  le.  17:1 
Sternolbyreoiileus  nm-i  le.  17-' 
Sternum.  2j.  .;  I 

ansle  of.  ^4  •  ,         - 

artiiulalionsof  rib-  "itb.  ii'i,  ", 

YuhW  of.  U 
(levelopnieiit  of.  ,^5 
foramen  of.  3<> 
srlailiolu^  of,  ,^4 
manubrium  of,  34 
not      's  of,  .u 
Niphoill  proiess  of,  ,u 
Straight  alKloiiiinal  muscle,  I'n 

il.velopnieiii.  i'i4 
Sivlohyoid  lit;anient.  1  n) 
Stvlobyoideus  mu-,!  le,  171 
funetions  of.  174 
nerve  supply  of,  174 
Styloid  liro.  ess  of  metaearpal  Imiie,  ■ 
of  railiu-.  .'s(i 
of  temporal  bone.  40.  =.>' 
of  ulna.  .-^.S 
Stvlonian.libular  ligament,  n."*.  I'^t 
Si'vlonia-loid  fora-iien.  40.  |;ii 
Styloinaxillary  licameiit,  i.'<4 
Suliai  romial  bursa,  20S 
Subareuale  fossa,  55 
Subelavian  groove,  v^ 
Subelavius  musele,  iW),  i6,S 
funetions  of,  I'lS 
nerve  supily  of,  I'lS 
Subeostal  angle.   ^; 
Subeostales  mus.  les.  1(10.  170 
Subcutaneous   bursa  ..1    ;anercisiiy 
tibia,  J,U 


Subcutanwus  rakaneal  bursa,  2,^ 
eolli  musele,  171 
digital  bursa'  dorsal,  -'0>S 
epieondvlar  bursa-,  20S 
external'  malleol.ir  bursa,  -■ ;  1 
infr.ipatellar  burs.i,  i,?<'.  -',' :  I 

inguinal  rini.'.  15,**  I 

internal  malleolar  bursa,  -VU  , 

metaiarjioph.il.iiigeal  bursa-, dorsal, 

oleeranal  bursa,  .'fS 
prepaiell.ir  burs,i.  i,('>,  J.?4  1 

troibanteric  bursa.  2,^.^  > 

!    SulKielloid  bursa.  iH(i,  ;o,S  1 

1    Sulifas.ial  prepatellar  bursa,  I s<> 
I    SulHieeipit.d  triangle.  15(1     ^  I 

I   Subseapul.ir  bursa,  i-m,  iS.S  | 

I        fasei      -07 
fossa,  f ., 
Subsiapularis  mus(  le.  iS;. 
I  funetions  of.  1-^* 

nerve  suppb     ■'.  i--*"^     . 
Subtendin--..    '-    '         "'"•'''-    •'""■■ 
I  rior,  -•,,;,  i 

i  |„,-tt-rior.    ■  .^ 

,1,  .-  bur-a.  o^,- 

'     -anal  bursa,      -"^  ! 

I        i  A|.alellar  bursa,  i.^n  .  ! 

I    Sulius,  20 

arteriosus,  4!.  44 
of  frontal  bone,  (u 
of  parietal  iKine,  50  i 

1  ,,t  spbelloiil  bone,  50  j 

I  ,,f  Knip  ir.il  bone.  5,5 

'        ealeaneus,  l-D- 

ihiasmalis.  41,  .|.S 
gluteal.  -',i-'^ 
,        nervi  spinalis,  :i 
i        tali,  102 

'        venosiis.  of  pariet.d  bone.  50 
\    Superiiliarv  arilu-s.  (10 
i    Superli.  iai  fas.  ia,  general,  id^ 
I        head  of  tl,-xori.olliiisbrev.smus,le, 

'  too 

laver  of  .  ,01  niuseles.  .-lo 
'of  cervii.d  fascia.  177 
of  ,-\leiisors  of  forc-.uni.  icjd 
,,f  |l,-\or  muscles  of  fon-.irni.  101 
l„,M,-ri"r    sa.ro.  oe.ygeal    ligantent. 

tc-niporal  f.is,  la.  e^t 
Suiieri.-r  angle  of  s,  upula.  .S;.  S4 
aperture  of  p.-Kis.  1  ,!0 

,,f  tvm]iani.   .  analii  uliis.  ;; 
articular  proci-ssc-s  of  sacrum.  -•., 

^i,rf,i.c-s  of  tibia,  cjc) 
bill-.-  of  onii  hvoideus  musi  le,   17.? 
biei'pll..l  bursa,  .\u 
bordc-r  of  -,  apul.i.  .•-<  I 
,,,rnu  of  fas.,     lata.  .',?-• 
(■os(otransvc-rs.- ligament,  i  m 
,rus  .if  sub.  utani-ous  inguinal  ring 

is.S 
extremity  ..f  femu.-   i)7 
of  I'diula.  ici 
,,f  humerus,  .'^i 
„f  ra-lK:-,-^'^ 
of  tibia,  .|.| 


Miixili,r 


iuperior  extremity  of  ulna, 

gluteal  line-.  .11 

inti-rvcrlebt.il  notch.  .'.< 

n-..irgin  of  scipula,  ."<.< 

niaxill.iry.  ('('.     Sn-  .lis 

mt-atus  of  nosi    oj.  77 

nuchal  line-.  41.  4'i 

cKcipital  fossa-.  4(1 

orbital  lissurc-,  .^7,  4-',  40-  74-  7.? 
pi-r..m-al  reiinacidum,  -\!o 
|,(trosal  griH.ve.  4,^.  S.s  . 

pill.ir.if  sub.  utani-ous  inguinal  ring, 

pubic   ligani. '  '.  i-'S 
ramus  .if  is.i  .uni.  .14 

of  pubis,  c);.  1)5 
surface-  of  t.ilus,  lOJ 
tcmp.ir.il  line.  5,; 
thora.i.  apc-rture.  ,Vs 
transvc-rsc-  ligam(-nt.  i-'o 
lurbinali-d  bone,  b? 
vi-rlc-bral  notch. s,  2? 
Supernum.-rary  b..ncs,  ,~<J 
Supii..ilion.  1  -4 
Sui'inator  brevis  :nusc  le,  lOS 
longus  niu-c  Ic-.  1.14 
muscle.  oSs.  11).; 
funi4ion  of.  11)'' 
nerve  su|.ply  of,  i')() 
ridge-,  S7 
Sui.raclavi.  ui.ir  fos-a,  lesser.  1,1 
Suprac.inihioi.i  pro.iss,  87^ 
SupragU-n.'iidal  tuberosity.  .^4 
Sujiralnoicl  nnisc  le-s,  17.1 
Supran.    •Iciiel  ridge,  ,s2 
Siipramealal  spine.  ,.' 
Supr.iorbiial  b.,r.l.r  ..f   fn.ntal    b.me, 
(.0 
f.iramen,  <io.  75,  7'i 
margin,  75 
n.)t.  h,  ^10,  7s 
Suprapat.l!.;-  bursa,  l.'-.^.  2U 
Supraspinatus  fascia.  2C7 
f,,„a  ..t  s.  apul.i.  -'^1 
mils.  ic-.  1S5.  iSd 
function  ol.  1^7 
I,.- .e- supply  of.  i-'*7 
Supras|.in.-us  ligame  iit,  '  1 -■ 
Surgical  nc-e  k  of  humerus,  S(i 
Suste-ntae  uluni  tali.  IC  ? 
S  u  ira  me-n.lo-a.  47,  -"--i 
Sulura-  si-rr,iia-.  5.1 
Suture-.  107 

coronal.  },t\  ,^7-  7'' 
cthmoidi-omaxill.iry 

frontal,  '10.  ?<i 

frontoetlinioiilal,  41- 
I       frontol.iehrvmal, 
I        fronlomaxiilarv. 
i       harmonic  .  t^7 
'        in.  isivi-,  Ihi.  .^1 

infra. erbital.  '1,^,  Si 
I       intermaxill.i'^  .  .(7.  ^o 

internasal.   ;;.  ''s    ^o 
I       laehrvmoeon.  Iial.  fvD  ^ 

l.i.hrym. .ethmoidal,  !^o 
1  laelirvmoniaxill.iry.  So 
i        lamlidoi.l,  .v'^.  7'1 


So 

,   (•!. 

So 
,  So 


Si 


-■*^ 


256 

Suture,  mcflian  palatine,  39,  81 
mendosal,  47,  81 
melopic,  60,  6j,  81 
nasofrimtal,  .^7,  b.s.  So 
nasomaxillary,  ,^7.  '15,  80 
oceipitomastdiil,  38,  40,  4,5,  53,  79 
,if  skull,  7<) 
jialatine,  median.  3(1,  81 

transverse,  31),  81 
palatiK'tlimoiclal,  80 
palatomaxillary,  80 
parictomastoiil,  38,  53,  79 
j)etr()stiuanit)sal,  81 
sagittal,  79 
serrate,  ^c),  107 
sphenoethmciiilal,  7<) 
sphenofnmtal.  37,  41.  4'>.  70 
si)hen<imaxillary.  81 
sphencKirliilal,  79 
sphenoparietal.  37,  3**.  4-.  70.  Si 
splienos<iuam<)sal,  38,  3(),  42,  43,  Si, 

80 
sphentwvKomatie.  37,  38,  50,  80 
squamosal,  38,  43.  5^,  70,  107 
squaint»somastoi<l.  53,  s9.  81 
transverse  palatine,  31).  81 
zVKomalirofronlal.  30,  37'  ^ 
z'yKomatieoinaxillary,  37,  39,  f>7,  80 
/vHomalieo!eniporal,  i,!^,  52,  80 
Symphvsis,  107 
pubis,  91;,  Ii8 
saeruicHiy^jeal.  1 13 
Synarlhri'sis,  107 
mixed,  107 
pelvic,  i.'.8 
Synihnnilro-is,  107 
epiphyseo~,  ji 
interiii  lipilal,  anterior.  47 

|)osleriur.  17 
inu-r-plunoidal,  51.81 
inlr.ioKipilal.  .interior.  Si 

posterior.  81 
petrtHH  <  .pita!.  St ,  1  iS 
splieniHui  ipilal,   |r.  4v  47'  St 
sphenopiiro~al.  81,  1  :S 
sternal,  31.  '  I7 
Synde^niotogy.  107 
ddniiiion.  17 
jji-ner.d.  107 
'-pel  i.il.  1 10 
Synde-mo-is.  107 
libiolilailar.  1  t'l,  13" 
I  rue,  107 
Syneri!i~l>,  t  1  < 
.^\no\i.t.  i^S 
Swiovial  hur-a-.   inS 

lominiini'.ilMiu.  108 
fold-.  108 

patellar,  i  t; 
laver  of  .irti.  iilar  1  ap~ule, 
inenibraiie.  ioS 
.-li.alli-ofd.ir-.di.irp.ilIiKaMienl..'^ 
I'f  linfi*  rs.  205 

of  lleyor  lelidon.  of  palm,  .'05 
of  fiuil, 


INDEX. 

Talocalcaneal  articulation,  137,  138 
.nterior,  138 
ligament,  anterior,  140 
external,  140 
internal.  140 
interosseous,  140 
posterior,  140 
Talocalcaneonavicular       arliculation. 

1,^7.  ',^S 
Talocrural  articulation,  137 
Talofibular  ligament,  anterior,  140 

posterior,  140 
Talonavii  ular  articulation,  13S 

ligani'  nt.  ilorsal.  140 
Talotibial  lieament,  anterior,  139 

[)Osler:    r,  139 
Talus,  lOi 

articular  facets  of.  \o! 
articulations  of,  137 
binly  of,  loi 
(bvelopment,  106 
gr(H)Ve  of,  102 
head  of,  102,  103 
neck  of.  102,  103 
surfaces  of,  102 
Tarsal  iMines.  i^2,   102 

articulations  of,  137,  138 
development,  106 
ligaments,  139 
dorsal.  14° 
plantar.  141 
Tarsometatarsal     artic  ul.itions, 

ligamenls,  dorsal,  141 
plantar,  141 
Tarsus,  102 
I        articulations  of.  137.  13S 
ligaments  of,  131) 
sinus  of,  102,  103 
transverse  artic  illation  of.  138 
Tectorial  mendirane.  111.  115 
Teeth,  alvc-oli  tor.  08,  71 
incisor,  in  fetus.  («) 
SOI  kets  of.  fi8.  71 
Tegmen  tvnipani.  5;.  57 
TciniMmd  lionc-.  57.  38.  !;i 
artic  ular  eminence  of,  53 
canal-  of    57 
development  of    58 
in  newborn,  58,  51).  81 


108 


i,?7 


iriferictr  procc-^ 


..f.  57 


of  iMTona  ii-'  longu- 

ill!     i/^K 


-31 


Systematic  an.itoniy.  cletinilion.  17 


mantoid  portion  of.   vH,  |o.  5.'.  s! 
pctroii-  piirlion  cif.  40.  52,  51 

ape  \  of.  -^ 
pyrai  lid  of,  5.'.  5 1 

a|H'\  ol.  ^^ 
scpianiou-  potiioM  of.   (8.   40,    It. 

iMiipaiiii    |iortioii  ol,  38,    40,    5.', 

'  '!7 
fascia.  18 1 
fo^a.  iS 
line'    1 1.  'CO 

inferior,  5c) 

superior,  ^'}0 
priMi>-  of /\goniaiic   bone.  71 
ridge.  38 
surface  of /ygoin.ilic    i~.cic  ,  Ji 


Temiwral  surface  of  sphcnoici   bone, 

49.  50  .         ,  , 

of  squamous  [xirtion  of  temporal 

bone,  52 
wings  of  sphcnoici  lione,  47.  41) 
Tem[K)ralis  muscle-,  182,  183 
functions  of,  1S3 
nerve  supplv  of.  183 
Temporomandibular  articiilation.  118 

ligament,  1 18 
TemiKiromaxiilary  articulalion,  1 1 , 
Tendinous  adductor  opening,  217 
arches,  143 
inscriptions,  143 

of  rectus  alKlominis,  I'li 
Tendc)  .\chillis,  220 
Tenclons,  142 

central,  of  .liaphragm,  1(14,  163 
chiasma  of,  207 
flexor,  of  palm.  205 
of  fingers,  i-xlensor,  204 
of  hand,  I'xtensor,  203 
of  long  head  of  biceps,  121 
of  palm,  205 
retinae  Ilia,  142,  143 
vincula,  207 
Tendon-sheaths,  143 
Tensor  fascia-  lata-  muscle,  200,  213 
function  of.  214 
nerve  supply  of.  214 
tvmpani,  semicanal  for,  58 
Teres  major  muscle,  185,  187 
function  of.  187 
nerve  -upply  of.  1S7 
minor  muscle-.  185.  187 
func lion  eif,  187 
nerve  sup]  Iv  of.  187 
Terminal  line-  of  ilium.  1)5 
Thenar  eminence--,  ojS 

muscles  of.  ie)9 
Thigh,  addiiifor  musiles  of,  2 if) 
anteiior  -.urfaee-  of,  muscles  of,  214 
fascia-  of.  2U 
flexors  of,  218 
intt-rnal  muscles  of.  Jift 
niusc  Ic-s  of.  21  4 

( lassilie  ,ition.  235 
iwisterior  muse  le-  of,  218 
Third  cuneiform  bone-,  104 

trcKhantcr,  i)8 
Thoracic  mu-ile-    I'l'i 

velle-bl.'e.   J'l 
elevc-nlli,  2(),  27 
lir,I.  26 

walK,  musilc-s  of,  I'n) 
Thorax,  22,  35 

ii]«Tture'-  of,  (5 

iiuiMles  of,  ififi 

w.ilU  ol.  mu-iles  ..f,  1(1 1 
Thumb,  bone-  of,  92 

i.irpomilae.irpal  joint  of.  1 -' t    i.-; 

nnlacarpophal.ingicil.iriiiul.itionof. 

I -'7 
Thvreolivoiiliu-  mu-c  Ic-.  17.-.  i:t 

■ril.i.l,   82,  <)e( 

anil  libul.l.  rel.nioiis,  ini 
.irtieul.ir  -iirfaces  of,  inferior,  too 


INDEX. 


-.•)/ 


Tibia,  articulations  nf,  i,?6 

borders  of,  loo  1 

condyles  of,  99 
crest  of,  100 
developmiiu,  ici 

extremities  nf,  go  ' 

interosseous  membrane  of,  1.^6,  137   [ 
shaft  of,  W.  100  , 

surfaces  of  inferior  extremity  of,  <)i)   j 

of  shaft  of,  100  ; 

of  >u|ieric)r  extremity  nf,  i)0  | 

lulxTosily    of,    subcutaneous   bursa 

of,  234  ' 

Tibial  lateral  liRamenl,  i,u 

Tibialis  anti-rior  nui>(  le,  !\o,  221,  1 

function  of,  221,  j 

nerve  supi>ly  of,  :;:>^  ' 

]H>^terior  niusi  le.  210,  2ni,  221  , 

function  of,  2^1  1 

nerve  supply  of,  221 

Tibiofil)ular  articulation,  1  ^6  ' 

>ynclesmosi'i,  i.^O,  1  57 
Tibionavicular  liKanurn,  i,V).  14° 
Tissue,  bony,  20 
TiK's,  articulations  (jf,  1  ^7 
lH)nes  of,  105 

great,  ball  of.  muscles  of,  220 
lif'r,  ball  of.  muscles  of,  2.'7 
To] -graphic  anatomy,  (litinilmn,  17 
Toru^  palatinus.  7S 
Tracheloina^toid  muscle,  151 
Tran^ver^alis  caiiitis  muscle,  151 
cervicis  muscle,  '.'i 
fascia,  16,5 
Transverse  articulation  of  tar-u^,  1  ^S 
capitular  ligament  of  foot,  i.t') 

of  h.inil,  127 
c.up.il  lipimcnt.  127.  205 
1  rur.il  ligament,  2  V4 
fasciculi,  2.<.! 
j;rcK)vc-,  n,  .((i 
head   of  ,cdcluctor  llallucl^   muscle. 

227 
ligament,  inferior.  121 

of  .11  la^,  1 14 

of  hip.  i,?i 

cif  knee,  i  ?4 

superior,  120 
lines  cif  re(lu->  aUlcimini-,  idi 
palatine  sutuie.  v(.  f^i 
plane,  I  7 

(Hirlion  of  nasalis  mu-de,  iXi 
prcK  esses  of  vertc  bra  .  .'  i 
TransverscHostal  mu>c  lc->.  is''-  1^," 
Tran-.versospinalis  mu-c  le,    1  ici,    i^i, 

">" 
Transversu->  aUloimiti^    muscle,    157. 

ifK) 

(line  lions  of.  |02 
nerve  -uppK  cif.  idj 
nicnti  muscle,  iSi 
luic  lia'.  14(1.  i/ci 
Ihor.ic  i^.  I'").  1  70 
Trape/ium,  .H«j.  cjo 
Trapc  /ill    niu'-c  Ic,  14s 
(unctions  cif.  14I1 
nerve  supply  ci(.  14(1 
Trapc.-oiii,  .-:j.  t;c 
»7 


Trapezoid  liRamcnt,  120 
Triangle,  deltoidcH)pectoral,  ifi? 
femoral,  216 
lumbar,  147 
of  Petit,  147 
suboccipital.  I5t> 
Triangular  ligament,  i.sc),  1114 
Triangularis    labii    inferioris    muscle, 
i.Si 
superioris  muscle.  iSi 
muscle.  iSi 
sterni  muscle.  170 
Tricejcs  brae  hii  muscle,  142,  1S5,  iS<i 
function  of,  ic)0 
heads  of,  iS<).  icjo 
nerve  suiiply  of.  100 
sura*  muse  le-,  210.  21c) 
function  of.  220 
,  nerve  supiilv  of,  .'.-o 

Trigeminal  impression.  i,(,  .SS 
I    Tric|uetral  Inme.  .Sc).  c)o 
I    TrcKhanteric  bur^a,  212 

of  glula'us  maxinius,  2,v? 
I  meclius,  anterior,  2,v; 

jMcsterior,  212.  2^4 
i  minimus.  234 

.  r-ubcutancejus,  27,\ 

}        foss.i.  ci7 
TrcH  hanlers,  c)7 
greater.  c)7 
lesser.  c)7 
third.  e,S 
TrcKhlc.-e.  14.! 

cif  phalanges  of  fool,  105 

of  hand,  c)2 
of  lahi>,  102 
rnxhiear  area  of  humeru-,  S'l 
clepre-i-ion,  01.  70 
prcKess  of  ealc  anc  u--,  lo.i 
spine,  61 
Tr.ic  hoid  joint,  loej 
True  joints,  loS 

jH'Ivis,    I  (O 

rib>.  .?.<  ■ 
svndc-smosis.  107 

vertebra',  22 
Trunk,  mu^c  les  of,  1 4) 
ske  Icton  of.  22 
\ari.iliiins  in.  ,(> 
Tubcrc  le.  'O 
c  .ircitid,  jO 

c  cisi.d,  ligament  of,  1 1'l 
intcrconclvli.id,  extern, d    c)c) 

internal,  cii) 
jugul.ir,  4),  4'' 
nu-ntal,  72 
.ilituralcir,  anieiior,  115 

IMisterior,  nS 
c'f  ("hassaign.ic ,  2(1 
ii(  hunienis,  greater.  «? 

IC-SCT,    S5 

Cif  Lisfranc .  \! 

eif  neik  cif  rii)-,  ^2 

of  pubis,  1,; 

of  talus,  e\te  rnil,  102 

internal,  u" 
eif  tni|K'fiuin,  i)0 


Tubercle,  sc  cilene,  ,<2 
Tubercular  ridge,  gre-ater.  Sfi 

lesser,  Htt 
TuUrculum  c, erotic  um,  20 

sella',  41.  4'"^ 
TulR'rositas  atlanti'^,  25 
Tuberosities,  20 
coracciicl,  85 
e-ostal,  Sc; 
deltoid.  SO 
gluteal.  e)S 
infraglenciidal.  S( 
mas'^eteric,  72 
of  calcaneus,  !o; 
of  fifth  metatarsal  bone.  101; 
cif  lirst  mciatar-al  bone,  \r:% 
of  hard  palate.  40 
of  ilium,  c.s 
cif  isehiuni    c)0 
of  maxilla.  (17 
of  n.ivic  ular  Ixme,  lo? 
of  palate  bnne,  70 
of  r,idius,  .SS 
cif  sc.ipliciicl  Inine.  io( 
cif  tilii.i.  100 

subc  ut.ilieeius  bursa  of.  -\u 
of  uln.i.  ><- 
pterygoid,  72 
sacral,  2c) 
supraglenciiclal,  S4 
ungual.  C12,  10^ 
Tubular  bemcs.  ic| 
I  Turbin.ilc'd  Uines.  ^7.  77 
I  inferior.  <n.  '17.  77 

'  develcipment.  (14 

middle ,  (M 
sphc  noichcl,  4S 
superi'.' .  ti^ 
Tympanic    iiinulus.  Si 
antrum,  s  i.  ,SS 
e  analie  ulus,  ^S 

.1!"  ruirc'  of,  su|,,  ricir,  54 
gMcve.  ;; 
notch.  S7 
|Hirtion  ci(  tcni|icir.il  l«inc,  jS.  (o,  s-' 

.';7 
spines,  greater.  ^7 

lessee,  ^7 
Tvmpancim.isiciid  lis-uo  .  s ;.  ',' 
'l'ynipano-c|u,imcis.cl  li  -iirc ,  57 


liw,  S.    S7 

and  Kicliu-,  lilaliicn-.  S.) 
Unilers  cif,  S7 
devclcipmciil,  'SS 
evtremitie-  cif,  S7,  SS 
shaft  of,  S7 

siufac  es  cif.  S7 

Idii  n  c  arpal  inline  nee,  c)n 

held  of  tlcM"  '  o|'i  nhi.iris  im, 

cif  ptcin.ctur  le  re  -  nini  le,  Icil 
later.il  ligameiil,  i-'-'    1  -•'' 
noh  li.  Si 
I'nciform  bcmc.  Si,.  i,n 

prcH  es,i,  I,!. 

I'minale  pun  c     ,  (14 


?s8 

InRual  phalanges,  q2 
tuberosity,  O-J,  105 
Uniaxial  joints,  loi) 
I'nilocular  joints,  loS 
U|)!HT  am,  fxtensor  surface  of,  mus- 
lU-  of,  i8q 
flexor  surface  of,  niusi  les  of,  188 
muscles  of,  I^^5,  18S 
cl.issificaticHi,  jcx) 
cxtn'inity,  articulations  of,  119 
l)urs;e  of,  208 
fascia'  of,  207 
free,  skeleton  of,  85 
ligaments  of,  in) 
muscles  of.  185 

ilevelopnient,  2CX) 
skeleton  of.  82,  8? 
tlioraiic  niusdes  of,  166 
[wrtion  of  lon^us  <olli  niusde,  17(1 


Vacin.*;  nui'o-a'.  if.  I4.i 
Va(?inal  ligan" -11-,  i4,i 
of  fool.  2,)I 
prot  ess,  4().  51 

of  ti-m|ioral  bone.  5(1.  t;7 
Vastus  externum  nm-i  K  .  -'15 
internu'ilius  nni^i  le.  21s 
internu->  inu-i  Ic,  215 
laler.ilis  nin~c  le.  215 
niedialis  niu.i  li-,  215 
Vein,  s.iplunou-.  Kre.ii,  252 

vertelir.il.  lan.il  for.  2(1 
Vena  lav.il  opininKof  cliapliragm,  ifX) 
Ventral  an  h  of  vertebra.  22 
Verlebr.T.  22 

arc  he-  of.  2:.  2,^ 

artii  ul.ir  pnne^^se-;  of,  23 

iHKlie-  of,  22.  2.i 

.onneiiioii--  ol.  1 10 
laudale-.  ',^ 
icrviial,  2  i 

iharailer-.  of,  24 
hr-t.  2(.  -S 

anil  M.on.l.     .iriic  ul.Ulon^,     of, 

I  I  i 
(levelopnii  nl.   \l 
set  on<  1 .  2  t .  2  s 
ilivelo]Mnenl,  \i 


INDEX. 

Vcrtebraf,  cervical,  seventh,  24 
third  to  sixth,  24 
development,  31 
false,  22,  28 
fle.xion,  2,^ 
lumbar,  27 
lumbosacral,  .^0,  36 
l)edicles  of,  2,^ 
])rocesses  of,  2,^ 
j)rominens,  25 
root  of,  23 
rotatory,  23 

spinous  prcKC'iscs  of,  2,i 
supernumerary,  35 
thoracic,  2b 
hrsl.  2(> 
twelfth.  26,  27 
transverse  prcscesses  of,  23 
true,  22 
Vertebral  arches,  liRaments  Inlwcen, 
112 
artery,  25 

canal  for,  :(> 
bonier  of  sc  apuhl.  83 
canal,  31 
column.  22,  ^o 

articulation    cif    ribs    with,    116, 

117.  -■<>i 
I  ur\,iiure  of,  30 
development,  31 
intertransverse  ligaments  of.  1 12 
joint-    if,  1  10 
liK.imc  nls  of.  1 1 1 
movements  of,  1 13 
promontory  of.  30 
margin  of  scapula,  83 
nouhes.  23 
M-in,  can.il  for.  2b 
Vertical  i»irtioii  of  squanmu-  porlim 

of  temporal  Iwine,  52 
Vidian  c.inal.  so 
X'illi.  synini:d,  108 
X'incula.  I  t! 

of  lem'on.  207 
Visceral  iBines.  22 

Vitreous  t.dlles  of  111!    Umes,    I,) 

Volar  ba-.ii  liii.iin.iils.  127 
JKirder  of  radiu-.  .88 
of  uln.i.  87 


Volar  carpal  ligament,  208 

cariK)metac  arpal  ligament,  127 
Intercarpal  ligament,  17 
ligaments,  accessory,  127 
radicK-arpal  ligament,  126 
surface,  18 

of  radius,  88 

nf  ulna,  87 
Vomer,  y).  (15 
ala-  of.  (15 
develo|>ment,  66 

W.Ml.s  of  thorax,  muscles  of,  ific) 
Wings  of  sphenoid  iKine,  47,  4c| 
Wormian  lionc-,  82 
Wrist -joint,  121 


XiPHOili  proces-,  34 
foramen  of,  3!) 


Vl.I.l.O'.v  bonc--marro\v,  21 


Zona  orbicularis.  132 
Zygom.'    70 

Zygoni         anil.  38,  30,  40 
'  [Mine      o.  70 

dc  \     .ipment.  7t 
serial  c-s  of,  71 
iKirder  of  sphenoid  Ixine,  50 
fossa,  711 
head   of   i|uadratus  labn  su|HTioris 

muscle,    I. So 
process  of  frontal  iKine.  60 
of  maxilla.  66.  67 
of  teni|ioral  iMine.  36,  38.  31).  52 
/ygoniaticof.ici.il  foramen,  71 
Zvgomatiiofronlal  sutun  .  36.  37.  80 
i    Zygomatic  oni.ixillary    suture-.    37,    .3ci. 

'67,80 
I   Zygomaticoorbii.d  for.imcn,  71,  7"; 
I    Zvgomatiioiem|Hiral  foramen,  71 
'        suture.  38.  S2.  '^o 
Zvgomatii  us  maior  muscle,  ISO 
ntinor  muscle,  180 
I       muscles,  i.So 


I»^ 


^ 


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l..|in   II.  t".!!.!...!!,  MI). 

(K-orm-  I  iou^tiin.  Ml). 
I  ulvic  ll.klDcn,  M.I). 
drxiU,-  Il<.r»iiz,  M.I). 
All,.'ii  K-ilit-r,  M.n. 
K.iil  I  lu-i.iv  I  iiiiiaii'k'i.  Ml) 
llian>fiii(l  l.ewi-.  Ml). 
K.  W.  I.ovitt,  MI) 
\V    I..  MaiDonal.l.  Ml). 
i:.lv(,iil  Martin,  \l .  I ). 
Ku.l..li,li  Matas,  Ml). 
Cli.is    A    Mayo,  M.D. 
Will,  i.  May.-,  M  I'. 
Mai    \Vallir  1 1    M><  aw 


11.  (1.  A    Mi>>nihan.  l-.K.C.S. 
I.  (1    Munifor.l,  Ml). 
I„liu  C.  Munio,  Ml). 
John  H.  Murphy,  M.D. 
E.  II.  Nichols,  M.l). 
A.  I.  DdiMier,  M  U. 
William  Dskr,  M  D. 
K.limincl  Owen,  K.K  <  .S 
Jm„.  Kansohott.  M  1 ). 

l;tii;.  C.cn.  K.  M.  '  )RiilIy 

.\.lniiral  I'   M.  Ki\cy, 

John  U.  KohiTt-,  M.n. 

A.W  .  Mayo  Kotison,  K.K.l'.S 

\V.  1.   Koilnian,  Ml) 

r.uRcne  A   Smith,  MI). 

ll.irmon  Smith,  M  D. 

Wm    i;.  Spillct,  M.I). 

Wellcr  Van  IltMik,  MI). 

J.  I'.  Warlasse,  M.D. 

K.  (  .  Wood,  M.n 

{;...r;T..  W.«i!".ry.  M.l). 

Hugh  II    NiniiK,  MI). 


SlAo/t/iy    AXn    AXAIOMV. 


Fowler's 
Treatise  on  Surgery 


IN  TWO  VOLUMES 


A  Treatise  on  Surgery.  Hy  Gk()i<(;k  R.  I'owlkk.  M.D.,  Professor 
of  Surgery  (Emeritus),  New  York  I'olyrlinic  .  Sur^cim  to  the  Metho- 
dist Episcopal  (Seney)  Hospital,  Brooklyn  ;  Surgeon-in- Chief  to  the 
Brooklyn  Hospital.  Two  imperial  octavo  volunus  of  725  ]>a!:;es  each, 
containing  S88  original  text-illustration-^  and  4  colored  plates.  IV.  set : 
Cloth,  ;gl  5.00  net ;   1  lalf  Morocco.  $17.00  net. 

JUST    READY 
WITW   888   ORIGINAL    ILLUSTRATIONS 

This  entifly  r,.  w  w.irk  preNCnts  iho  sc  icnc  ;inil  art  of  Miri;tTy  as  it  is  prac- 
tised to-day.  i  •  irst  part  of  the  worlt  ilc.ils  wuh  ^cner.il  siirj^ery.  aril  eiiitirares 
what  is  usually  irn  lulled  under  the  head  of  print  iplcs  of  surgery.  Special  .ilten- 
tiiin  is  Kivpn  tn  the  suhject  of  intl\iiini.ition  from  the  surueon's  point  of  vie.v. 
due  (-<msidcration  heinK  accorded  the  inlhicni  cs  of  trauiiialisni  and  bacterial  in- 
fection as  the  predisposin},'  ami  e\(  itinj;  lanses  of  this  <  nndition  Then  follow 
sections  on  the  injuries  and  diseases  of  separ.itc  tissues,  ^^unslioi  injuries,  ai  ule 
wound  diseases,  diionii  sur^iial  infci  lions  (uu  hiding'  syphilis),  tumors,  surgical 
operations  in  general.  foreiK'n  bodies,  ,ind  bandaijin!;.  'Iho  se>  1  nd  part  of  the 
work  is  really  the  clinical  portion,  devond  to  re-ional  smtjcry.  Ilercin  the 
author  cspci  ially  endeaiois  to  rmph.isi/e  those  ,n|  iries  and  siirj^ii  al  diseases  that 
arc  of  the  greatest  import, in<e,  not  onlv  bei  ausi  of  their  fiicpicm  > ,  but  .ilso 
because  of  the  dilVn  ully  of  dia^;nosis  and  the  spei  iai  (are  demanded  in  then  treat- 
ment.    The  text  is  elabiuately  illusliated  with  enti-ely  new  and  on>;inal  ilhistra- 


Rudolph  MalM,  M.  D..  rtvfu,<r  of  Sni\:,,v.  Inlni.-  r»i:,  r</fy  ,-^  / ,;,i.:.,fi,t. 

'■.\IUi  ..  .  a..:..:   .  \..ir.;il..I,   ii   111"  Ifii^    v^.l'L    t    .i;r.    ..i.i  :   ■       :  u;- r=i  ;•  t't ^-y' '--^   i..:!v  -  ..: 

«»«uri»nLt-  1  rnltrtaiitra  .    'llial  tliis  w.irlt  wtuil.l  pii.vt  .t  itM  I Iv  "I   Iti^li    .-i.trr  ami  <l<-.mi.  t   liif tit 

••>ltndid  v..|umfi  (ully  jtntify  the  re(mH'  of  ilinir  aiitli"r  Imi     iriii»im-^s.  lli..|.ii,!hii.«»,  aii.l  Icarninu  " 


SAUA'DERS-  BOOKS   ON 


Howard  A.  Kelly 

and  C.  HURDON  on  the 

Vermiform  Appendix 

RECENTLY  ISSUED-AN   AUTHORITATIVE   WORK 


The  Vermiform  Appendix  and  Its  Diseases.  By  Howard  A. 
Kki.i.y,  M.  I).,  Professor  of  (}ynecology  in  the  Johns  Hopkins  Univer- 
sity, Halliniorc  ;  and  K.  HuKUON,  M.  D..  Assistant  in  Gynecology  in  the 
Johns  Hopkins  University,  Baltimore.  Haiulsome  octavo  volume  of 
827  pages,  containing  399  superb  original  illustrations  and  3  litho- 
graphic plates.  Cloth,  .^lio.oo  net ;  Half  Morocco,  $1  i.oo  net. 

WITH  399  SUPERB  ORIGINAL   ILLUSTRATIONS 


This  work  is  one  of  the  most  niaRnifirent  medical  books  ever  published,  con- 
t...nmK  some  four  hundred  beautiful  illustr.itions.  in  the  preparat-on  of  which  the 
artists"of  the  Johns  Hopkins  Hospital  have  spent  many  years.    IlarN  beautifully  and 
.ir.uratelv  portrays  the  condition  represented,  and  together  they  form  a  magnifi- 
cent collection  unequaled  by  those  in  any  other  work  on  the  subject  ever  placed 
upon  the  market.     \  large  amount  of  original  work  has  been  done  for  the  ana- 
tomic chapter,  f(,r  which  over  one  hundred  original  illustrati.ms  have  been         le. 
Afp.mlutlh  naturally  receives  the  fullest  consideration.      The  pathology  is  not 
only  amply   ind  clearly  dcscnbe.l.  but  it  is  beautifully  illuminated  with  an  abun- 
dance of  Illustrations  depi.  ting  the  pathologic  conditions  with  rare  fidelity.     Diag- 
nosis and  treatment,  by  far  the  most  important  sections  to  the  practitioner  and 
surgeon,  are  elaborately  discussed  and  pr,.fusely  illustrated.     Special  chapters  are 
devoted  to  the  peculiarities  of  appcnduiti-  in  children,  and  to  the  characteristics 
of  the  vermiform  appendix  in  typhoid  fever.     A  valuable  chapter  is  that  on  the 
mediiologal  status  i>f  appendicitis. 

Briliih  Medicsl  Journal 

•  h  i.i..h.'5  till-  liiKh.w.iIrr  m.irk  ..f  n..'.|ir,,l  m.mnKr.l|*.  hmh  in  rrR.ir.l  l..  in.-  ,<-aoiMiB, 
rrsMrrl,,  .,„.»  clinu-.il  r,a.„„inK  of  ihc  toxi.  and  in  the  .,u.,liiy  of  its  illuMrUion..  IIr-so  are 
really  maKnificont." 


\   i 


SURGEK  y  AND  ASA  TOM  1 


Kelly  and  Noble's 
Gynecology 
and  Abdominal  Surgery 


aynecology  and  Abdominal  Surgery,  lulited  liy  Hhwaki.  A. 
Kia.LY,  M.  1).,  I'rofcssor  of  Gynecology  in  Johns  Hopkins  UnivcrMty  ; 
and  Chaklks  P.  Noble,  M.  D.,  Clinical  Proft-ssor  of  Gynecology  in  the 
Woman's  Medical  College,  Philadelphia.  Two  imperial  octavo  volumes 
of  ipo  pages  each,  containing  650  original  illustrations,  some  in  colors. 

IN   TWO  VOLUMES- VOLUME  I   JUST   READY 

WITH  6S0  ILLUSTRATIONS   BY        *X   BRODEL  AND  HERMANN  BECKER 

In  view  of  the  intimate  as-sotiation  of  ,     neclojry  with  alnlominal  surgery  the 
eait.)rs  have  combined  these  two  important  subjects  in  one  work,     for  this  reason 
the  work  will  be  doubly  vaUialile,  fur  not  only  the  j;ynecolot;i.st  and  j^cncral   prac- 
titioner will  tind  it  an  exhaustive  treatise,  but  the  surgeon  also  «ill  tind  litre  the 
latest  te  hnic   of  the  various  al)do-iiinal   operations.      It  poss.      .  s  a    nuudicr  of 
valuable  features  not  to  be  f  mnd  in  any  othe;  publication  <  ovenn-  the  s.iuk-  li.lds. 
It  contains  a  chapter  upon  the  bacterio^.^'y  and  one  upon  the  |iatholo-y  of  >;>ne- 
coloCT.  dealin;;  fully  with   the  s.  ieatific   basis  of  f,'yne((ilot;v.      In  no  other  uork 
can   this   information.    pre|ared   by   specialists,   be    found   as   scpaial.-   .  hapters. 
There  is  a  large  chapter  devoted  entuely  to  m,,/h;i/  .i,MV/rV,'/.!:r.  written  e>pe,  i.dly 
for  the  physician  en-agcl  in  general   pr.i.  tice.      lieremfore  o,.    gencr.d  |ua(ti- 
tioner  was  compelled  to  search  through  an  entire  work  in  order  to  obtain  the  in- 
formation desired.       .  J/',/.w;;;.i/  w^/.v/t   proper,   a.  distin.  t   from  t;\  nei clogy.   is 
fully  treated,  embracing  operations  upcm  the  stoma,  h,  ujion  the  iniestmcs.  uiion 
the  liver  and  bile-ducts,  upon  the  pam  reas  and  spleen,  upon  the  kidn.vs,  ureter. 
bladder,    and    the    peritoneum.      Special    atten*   .n    has    b.-.-n    guen    to    wo./.m 
l.rhni,    and  illustrations  of  the  very  highest  order  h.ive  been  used  to   make   clear 
the    various   steps  of   the  operations.        Indeed    the   illustrations  are    Irulv   mag- 
nificent,  being  Ihe    «..,k  of  Mr.    Max  liriiL:  and    >!■-.    ,'/-'-«••.••••-■■■  /••    '   -     '  !   the 
Johns  Hopkins  Hospital. 


SAi'XDEKS'   UDOKS  OX 


Moynihan's 
Abdominal  Operations 


b  fi 


Abdominal   Operations.     By  B.  G   A.  Moyniuan.  M.S.  (Lond.), 
F.R.C.S.,  Senior  Assi.stant  Surgeon,  Lewis  General  Infirmary,  England. 
Octavo,  beautifully  illustrated.    Cloth,  Sj-Oonet ;  1  lalf  Morocco,  .S8.00  net. 
JUST  ISSUED-  NEW  (2nd)  EDITION 
TWO   LARGE   EDITIONS   IN   ONE  YEAR 

It  has  Vjeen  said  nf  Mr.  Moynihan  that  in  describin;,'  det.iils  of  operations  he 
is  at  his  best.  I'he  appearance  of  this,  his  latest  work,  therefore,  will  be  widely 
welcomed  by  the  medical  profession,  ^'iv  in<,',  as  it  does,  in  most  clear  and  exact 
lan^'uane,  not  only  the  actual  miu/iis  op.iamii  of  the  various  abdon  '.lal  operations, 
but  also  the  preliminary  technic  of  preparation  and  sterilization.  Complications 
and  scquel.i;  and  after-treatment  are  presented  in  the  same  clear,  ( lean-cut  manner 
as  the  operations  themselves.   The  beautiful  illustrations  have  been  especially  drawn. 

Edward  Martin,  M.  D. 

I'r.'ftswr  of  Clinh.it  Siit\',-ry.  Vnr.frutv  of  I'fnn<ylv,v!i.i 

•'  It  is  ;i  wonderfully  Rood  Look.  II.-  lias  .u  liii-vcd  tompli'te  suir<";s  iii  iniislraiiiiK,  both 
by  words  and  pictures,  the  hesi  le,  I.mk  ..f  die  alHloiiiiii.il  oper.iiions  no«  eoninionly  performed. 


Moynihan  on  Gall-stones 

Gall-stones  and  Their  Surgical  Treatment.  By  B.  G.  A.  Moyni- 
han, M.S.  (LoNi).).  F.R.C.S.,  Senior  Assistant  Surgeon,  Leeds  General 
Infirmary,  I'jigland.  Octavo  of  .;38  pa^es,  fully  illustrated.  Cloth. 
$  5.00  net ;   Half  Morocco,  JS  6.00  net. 

RECENTLY   ISSUED— NEW    2d  1    EDITION 

Mr.  Moynihan,  in  revising;  his  book,  has  made  many  additions  to  the  text,  so 
as  to  include  the  most  re<  ent  advam  t-s.  i;s|M'cial  attention  has  been  K'^en  to  a 
detailed  description  of  the  early  symptoms  in  i  holelithiasis,  enablini;  a  diajjnosis 
to  lie  made  in  the  .ta-e  in  uhirh  sursjical  treatMcnt  >  an  be  most  safely  adopted. 
Kvery  phrase  of  >;all  stone  disease  is  dealt  with,  and  is  illustrated  by  a  larRC 
number  of  clinical  records.  The  account  of  the  operative  treatment  of  all  the 
forms  and  <  (implications  of  gall  stone  disease  is  full  and  accurate.  A  number  of 
the  illustrations  are  in  lolor. 

Britiih  Medical  Journal 

■  He  expresses  Ins  views  with  admirable  ele.irne55,  ,ind  he  supp.irts  llieni  l.v  a  l.iri;e  num- 
ber ,.f  ilinicd  <.«Hn.ples.  vvhieh  will  b-  nuleh  prue.l  by  iho.e  wlm  kllo^^  tl,e  difficult  problem. 
and  tasks  which  g.ill-sione  surRerv  not  infreipienlly  presents." 


i:.J'  ..H 


srA'(;/:/n-  a\o  axatomv 


Sc\idder*s 
Treatment  of  Fractures 

WITH  NOTES  ON  DISLOCATIONS 

The  Treatment  of  Fractures:  with  N-.to^  on  a  few  Comnmn 
Dislocations.  Hy  Cmaklks  L.  Scui.ukk.  M.  D.,  Sup^ch  to  the  Massa- 
chusetts General  Hospitil,  Boston.  Octavo  volume  of  562  pa-es 
with  736  original  illustrations.  I'olished  Huckrani.  S500  net;  Half 
Morocco,  !56.00  net. 

RECENTLY   ISSUED    NEW   (5th)   EDITiON.   ENLARGED 
riVE  LARGE   EDITIONS   IN   LESS  THAN  FIVE  YEARS 

Five  lar^e  editions  of  this  remarkable  work  have  been  <  alic.l  for  in  less  than 
nve  years.  Kor  this  new  fifth  e.lition  Dr.  Srudder  ha.  n.ado  nun.evm.s  .uM>t,un. 
throuehont  the  text,  and  has  ad.led  s..n,e  fifty  new  ilhist.a.ions,  KnatK  rnhanrmR 
the  value  of  the  work.  The  articles  on  D.slo.at.ms,  >ll.>str,,te.l  in  that  pra.lu.-,! 
manner  which  has  made  Dr.  Scuddcrs  work  so  useful,  will  l.e  foun.l  eMrenuly 
valuable. 

JoKVh  D.  B-yMit.  M.D..   rro/..u„- of  !'„■  r.mctl.s  -m,/  /V,„y^,■  of  Su,;,ry,  Vnu.r.,, 
and  HfU,:u,-  llo  /■it.ll  .U.,il,.l/  ('.'//^V''. 
•■.\s  .>  praclK-.il  ,U-nu)nstrat...,.  ol  ll,.-  mpic  a  .s  t-xclU-nl,  an.l  ...  an  >-xrin.|.l.-  uf  Iwuknuika.g 
a  Is  higlily  commemlable." 


BickhamN  Operative  Surgjery 

A  Text-Book  of  Op  •..  Surgery.  Hy  W akki  n  St.im;  Uk  kii.vm, 
M.D.  I'liAK.  M.,  Visitino  ^^urs,-e<m  to  Charity  Hospital  an.l  to  Touro 
Hospital  New  Orleans.  (  ktavo  of  lOOO  pa-es.  with  y,<,  he.u.tilui  illus- 
trations, nearly  all  ori-inal.     Cloth,  s6.oo  net ;  • '   't  Moroco.,  S7.00  net. 

RECENTLY  ISSUED.  2nd  EDITION-TWO  EDITIONS  IN  SIX  MONTHS 

This  absolutely  new  w..rk  completoly  ...vers  the  sar^iral  anatomy   and   ol«'-» 
live  technic    involved  in  the  operations  of  :^eniial   surKe.y.       I  he  pra.  tirabilits  of 
the  work  is  particularly  emphasized  m  the  55.,  ma.nnilicenl  dlustiations  whi.h  fon 
a  useful  and  strikini,'  feature. 
NicholM  Senn.  M.  D..   /Vo/;-!),.,-  of  S„.x.n ,  A'/o*  .I/.,/„,</  (■.•//..,•'■ 

•■,\.,„m-..v!Mlc.,r,-f..l.-x:..n,„Ml,„n   of  th,-   l.M   a,„l   ,l:„Mr,,t,.,n.  nf  I  .r   Hi,  kl,,„n\  l.n„k  ,.n 

()|„Ta(.v,-  Si,rt;..rv  has  s,.li-li.Ml  m,-  of  il.  nuiit-.       1  l„-  ..,,„k  «ill  n,.-.i  »« ,. ■•  <'.l  i....    .. 

ti-aclier-i,  sludents.  .inil  iinctitiom  r..  ' 


SAUNDERS'  BOOKS  ON 


Gould's  Operations  on  the 
Intestines  and  Stomach 

The  Technic  of  Operations  upon  the  Intestines  and  Stomach.     By 

Ai.FK'U)  H.  GouLi>,  M.  D.,  oi  Boston.     Large  octavo,  witli  19c  original 
illustrations,  sonic  in  colors.     Cloth,  S5.00  net  ;  Half  Morocco,  sO.oo  n^^^t. 

JUST  ISSUED 

Dr.  (loulds  new  work  is  the  result  nf  exhaustive  experiincntatiiin,  the  technic 
of  the  operations  descriheti  beinj;  simplilieJ  as  far  as  possible  by  experiments  on 
animals,  thus  leading;  to  the  development  of  many  new  features.  The  te.vt  is  pur- 
posely concise,  the  te(  hnic  bein;,'  presented  very  clearly  by  the  numerous  practical 
illustrations,  all  made  from  actual  operations  done  either  upon  the  animal  or  the 
human  bein^'.  As  the  success  of  i;astro-intestinal  surjjery  depends  upon  an  accur- 
ate knowlidf,'e  of  the  elementary  stejis,  a  thorou;.,'h  accoimt  of  repair  is  included, 
followed  by  a  full  description  of  all  the  important  stitches,  knots,  and  instruments 
used  in  intestinal  suri^ery. 


DaCosta's  Modern  Surgery 

Modern  Surgery — Gk.nkkai.  and  ( )i'i;KATivr..  By  John  C'jiai.mkks 
UaCd.sia,  M.  1).  ^'rofcs.sor  of  the  I'rinciplcs  of  Surgery  and  of  Clinical 
Surger>  in  the  Jefferson  Medic, il  College,  I'liiladelphia.  ()ctavo  of  1  283 
pages,  with  872  illustrations.  Cloth,  Si. 5')  net;  Half  Morocco,  Sf>.?o  net. 

JUST   ISSUED— THE   NEW  15th)  EDITION 

Kor  this  new  fifth  edition  the  work  has  been  entirely  rewritten  and  reset.  One 
hundred  new  practic  .il  lUuntiations  have  been  addcil  ;  .intl  the  work  has  been  en- 
larged by  the  addition  of  two  hundicd  p.ijjes.  lo  keep  the  book  of  a  si/e  to  handle 
conveniently,  a  thinner  but  hi^jh  grade  paper  has  been  used.  DaCost.i's  Surjfery 
in  this  edition  will  moie  than  maintain  the  reputation  already  won. 

The   M«dical  Record,  New  York 

■  1  !:-.■  '.\^Mk  t!:!''Ui:h"'it  U  n.tt;»hlf  f.ir  its  rnnris.'nr-;';,  P*..lnn(Innc''  of  t.mijuaut'  and  n:id- 
din)j  h.ivt*  titen  scrupuluuslv  .ivoulrd,  wliilf  ;it  Ihc  ^www  tinir  it  cont.iins  .1  sufficit-nl  am.nint  oi 
inforriuiiion  to  fulfil  thf  oli|iit  aimiil  :ii  by  its  aullii>r— naim-.y,  \  li-xt  liook  for  tl  ';  use  of  the 
student  and  the  Ijusi  pr.ici.uoner." 


.S7  A't/AA'f  ,L\7>  AXATOMS 


Schultze  and  Stewart's 
Topographic  Anatomy 

Atlas  and  Text-Book  o'  Topojcraphic  and  Applied  Anatomy.     \\y 

l*k()i'.  l)u.  C).  Sciiui.i/i;,  of  Wiirzburi;.  lAlitcil,  with  additions,  hy 
GKoK(iK  1).  SiEWAKT,  M.U.,  I'lofcssor  of  Anatomy  and  Clinical  Sur- 
gery, University  and  Ikllcvue  Hospital  Medic  il  Coile<:;e,  N.  Y,  I^r^e 
quarto  of  189  passes,  with  25  colored  fi^Mr-s  on  23  colored  litho<.rraphic 
plates,  and  Su  text-cuts,  Oo  in  colors.     C    -Ji,  ^SS-jo  net. 

RECENTLY   ISSUED 

It  was  IVofessdr  Schultze' s  special  aim,  in  preparing'  this  work,  to  produce  a 
Text-liook  and  .\tlas.  not  for  the  n.itomist  aWme,  but  more  partindarly  for  the 
general  practitioner.  The  value  of  the  knowledge  of  toponraphii  anatuniy  in  bed- 
side diajjnosis  is  eniphasi/ed  throujdiout  the  book.  1  he  many  colored  lithoyiaphic 
plates  are  exceptionally  excellent. 

Arthur  Dean  Bevan.  M.  D.,  /''.'A<""-  >■/ Smxery  in  Ki,s>:  M,,/i.,i!  CMx'\  Chic^: 

■■  I  i.q.iiil  Silr,ili/r  iin.l  Sliw.irl'<   Tcipc.sjr.ipliic-  ;iinl  Appli<  il  .Xiuiloiiu  .is  a  v<t)  [i.lniir.ible 
wurk,  for  MuJi'nIs  e5p'".ially,  ami  1  luiil  llu-  plales  ami  the  tfxt  ejicclk-ni." 


Sobotta  and  McMurrich's 
Human  Anatomy 

Atlas  and  Text-Book  of  Human  Anatomy.  In  Three  Volumes.  H;, 
J.  Siiiioi  r.\.  M.D..  of  Wlirzbur^.  lulited,  with  additions,  by  J.  I'i.avfaik 
McMt'KKicii,  A.  M.,  I'll,  n.,  Professor  of  Anatomy.  I'niversity  of  Mich- 
igan, Ann  Arbor.  Tliree  larije  ([uartos,  each  containing  about  250 
pages  of  text  and  over  300  illustrations,  mostly  in  color'-.  I'er  volume: 
Cloth,  Sfvoci  net. 

JUST    READY 

The  >Mcat  advanta},'e  of  this  over  other  similar  works  lies  in  the  larK'e  number 
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have  ever  l)een  produced  in  this  lield.       They  are  accurate  .ind  be.iutiful  r.,, reduc- 
tions of  the  \ariou5  anat'-mic  part=  reprrsrnted, 
Edward  Martin.  M.D.,  /'r./.^vr  .■/  Ohiiai/  S,i>x,iv,  Imv/ydtv,!   r,mivi.n,ij 

I  hi-,  i-,  .1   pi.c  of  ho.ikin.lUinK  «liKh    i^    IniU  ..tlnui.ililc.  willi    |.i  il.  -    in  I    t.M    -o  Ufll 
chose"  .itiil  so  il.  ,r  tint  til.'  \».Mk  I-  m..-!  u-  fiil  lo  lliu  |,r.Kti^in^  surE:i-"n." 


'■<'- 


SArXD/:KS'   h'OOA'S  (^V 


Eisendrath's 
Surgical  Diagnosis 

A  rext-B(K)k  of  Sureicai  Diagnosis.  Hy  Damil  N.  Kisknorath, 
Ml).  Ailjmict  rrofcssiir  .)f  Surgery  and  Clinical  Sur^'try.  Ci)liet^e  of 
riiysicians  ;iiul  Suri;eoiis,  Chicago.  Octavo  of  600  pages,  with  400  <  11- 
iiniy  new  aiui  orii^inai  tcxt-iilu.strations  ami  sonic  colored  plates.  Cloth, 
SU.^o  net  ;   Hair  Morocco,  ^S.oo  net. 

JUST   READY 

WITH  400  ORIGINAL  ILLUSTRATIONS 

()(  first  importance  in  every  sur^'ic:il  condition  is  .1  correct  Jiaijnosis,  for  upon 
this  ileppnUs  the  treatment  t<i  he  persued  ;  and  the  two— diagnosis  and  treatment- 
constitute  the  most  practical  part  of  joictical  surgery.  Dr.  Kisendrath  takes  up 
each  disease  and  injury  amendahlc  to  sur^iical  treatment,  and  sets  fortli  the  means 
of  correct  (lia<;nosis  in  a  systematic  mil  comprehensive  way.  Dchnite  directions 
as  to  methods  of  examination  are  inesented  clearly  and  concisely,  providing  for 
all  contin^jencies  that  mi-ht  arise  in  any  ^;iven  case.  The  ma^inilicent  illustr.itions, 
some  four  hundred  in  number,  arc  all  entirely  new  and  ori;,'inal,  havin;,'  lieen 
diawii  (lire,  lly  under  Dr.  I'.isendrath's  personal  supervision.  They  are  ni>l  only 
ex.  client  Irom  an  artistic  stan.lpoinl.  luit  also  from  a  pt.u  ti.  d  point  of  view,  for 
eai  h  one  indicates  precisely  how  to  diagnose  the  v.irious  i  onditions. 


Eisendrath's  Clinical  Anatomy 

A  Text-Book  of  Clinical  Anatomy.     Hy  1),\mki.  N   F.isKNDRATri, 

A  H.  M.  I)  ,  A'iiinut  I'rofessur  .if  Snrgci^'and  Clinu.il  SiirRoiy,  C.'ll<oc 
ol  I'hyski.ms  ,in.l  Surge. ms,  (liic.ii;...  ( )ct,ivo  .il  Si?  pages,  illustrated. 
(.1   Ml,  f,e,.oo  net ,  Sheep  or  Il.ilf  M.jrucco,  jgii.oo  net. 

RECENTLY   ISSUED 

This  new  anal.imy  discusses  the  mi1.|.  ■  t  from  the  .  Imi.  al  standpoint.  A  por- 
tion .if  .M.h  .hapler  is  <levoteil  I.,  the  e\.Miiinati..n  ..fill.-  Iuiuk'  thr..uj;h  palpati..n 
an.l  m..rkin>;  ..f  surla.  c  <M,lllne^  «l  l.n.linaiks,  vcvs.ls.  nerves,  thora.  »  an.l 
al)d..Monal  viscera.  Ihe  illustrations  ar.'  from  new  and  ori>;in.il  drawings  an.l 
photographs. 

MmUoI  Record,  New  York 

,\  s,,,.,    ,1    ,,im.'n.tiu..n  lur    Ui.-    tigurM  is  lh«i  ilirv  «rr  m..-.llv  .jr.>[.iial    .ii..l  wirr 

1.1.1.1.    I..r  il..-   i.iiri in  vi.w  1  lif  srclions  of  joiliK  .in.l  Ininkj  «r»  Ih.iw  .»f  f.>mi»Jllin«a 

i:uij>'r«  «nil  .ir«   unimiw.u  ImIiL  m  .i.r.irmy  ' 


;,?r^^ 


SUftGER  Y  AND  AXA  TOMY 


International 
Text-Book  of  Surgery 

SECOND  EDITION.  THOHOVGHLY  HEVISED  A.!!*  ENLARGED 

The  International  Text-Hook  of  Surgery,  In  two  \nluiius.  By 
American  and  Hritisli  authors,  lulitcd  l)y  J.  Coi.i.iNS  Wakkhn,  M.l)., 
LL.D.,  F.R.C.S.  (Hon.).  I'rofcssor  of  Surijcry.  Harvard  Mtilical 
School ;  anil  A.  I'e.xklk  ("ioild,  M.S.,  l'".R.C.S.,  of  LcmkIoii,  Kni^land. — 
Vol.  I.  Gemral  and  Opinitivi-  S/oxirv.  Royal  ort.ivo,  973  pai^'os, 
461  illustrations,  9  full-pat^c  colored  plates. — Vol.  11.  Sf<,;!,il  or 
Regional  Siin^vry.  Royal  octavo,  1 122  p.ivjes,  499  iliii.strations,  and 
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Americ&n 
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American  re.\t-li<H)k  of  Nursery.  I'.dit.  <1 1.\  W  \V  ki  1  \.  \1  I  •  ,  I  I  I  >  , 
l|o\  l.k.t'.S.,  \^.\^..  wii  I  hiN  ,  and  |  WiiiiWi  Winih,  .\1  I".  I'm  I> 
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■^■•*'.  vy".^  '•  ''> 


sAr^'D/■:J!'^''^  hooks  on 


American  Illustrated  Dictionary  New74th'Edition 

The  American  Illustrated  Medical  Dictionary.  With  tables 
of  Arteries,  Miis<  les,  Nerves,  Veins,  ett.  ;  of  liai  illi,  Hai  teria,  et(  .  ; 
Kiioiniuic  Tables  of  Diseases,  Operations.  Stains,  Tests,  etc.  By  W.  A. 
NnvMAN  DoKiANL",  M.l).  I jrgc  o< tavo,  840  pages.  Hexilile  leather, 
54.50  net ;  with  thnn;l)  inilev,  #5-oo  net. 
Howard  A.  Kelly.  M.D.,  /'/■,/..,..<- ,/(,>«f<.V,,4-,'.  /'A"'  H.'piins  I  nivnsih:  l<..lhm,Hf. 

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.1111111  ^\K.     No  trnirs  have  Ihtti  I. .1111. 1  in  iii>  us 


of  It. 


Golebiewski  and  Bailey's  Accident  Diseases 

Atlas  and  Epitome  of  Diseases  Caused  by  Accidents,      liv   1»R. 

Ku.  (Ini  1  iiiKWhKi,  of  Merlin.  Kdiled,  with  additions,  by  I'k.xkii-  Uaiikv, 
M.l).  Consulting  Neurologist  to  St.  I.nke's  Hospital,  New  Soik  (ity. 
With  71  (olored  figures  on  40  plates,  14.?  text-cuts,  and  549  l"t;e^  '^^ 
text    Clolli,  j;402  1"^''       ''"  StiiDK/tri'  J/,tn,/  A/An  X/iis. 

Helferich  and  Blood((ood  on  Fractures 

Atlas  and  Epitome  of  Traumatic    Fractures  and  Dislocations 

liv  I'Kiii.  Hk.  11.  Hi  I  1  IKK  H,  of  (ireifswuld,  Prussia.  I'.dUed,  « itli  ad- 
ditions,  by    l.isKiH  C.  I'.i M-  I>-,  Assot  iate   in   Surgery,  l.)lins 

Hopkins  L'niversity,  Itahiinore.  .iifi  .olored  figures  on  64  lithogniphu: 
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d,-. 


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Sultan  and  Coley  on  Abdominal  Hernias 

Atlas  and  Epitome  of  Abdominal  Hernias.  I'.v  I'k.  Dr.  (;  Si  1,- 
i\N,  of  ('..itlmgen  r'.ditrd,  with  adtlitions,  l.\  \V\i.  I!.  Cni.iA.  M.  D., 
(Iini<al  i.e.  Hirer  and  Instru.  tor  in  Surgery.  Coluinbia  I  niversity.  New 
York.  I  I.)  ilhistratioiis.  ,56  in  ( olors,  and  ^77  pages  of  text.  Cloth, 
f,\  00  net.      /'/  S,iiiii,l<r\'  /l,iii,/-  lt/,ii  Si'iis. 

Warren's  Surgical  Pathology  Edmon 

5urKical  PatholoKy  and  I  herapeutics.  Ity  J.  Coiiin^  W  \KKhN. 
Mil.  I  I,  |i.  I  |<  (S  '  ll"N  1.  I'rolessor  of  Surg.rv,  Harvard  Medi.  al 
Siluuil.  O.lavn.  .S;^  piges;  \  \t>  illustialions,  \\  in  lolois  Cloth, 
J(i;,oo  111  I  ;    llill  MoroiKi.  f,i>.oo  iiel 

Zuckjrkandl  and  DaCosta's  Surgery  Ed^^on 

Atlas  and  lipitome  of  OiH-Tative  Suritery.     Il\  Dk     <»    /i.kkk 
KVNi.i.  ..I  Vienna       r.dile.l,  with  a.lditn.ns.  bv    |    Ciiaimkks  DaCo>ia, 
M  D.  I'lof.-.sor  of  the  I'nnnpl.s  ..f  S.iigerv  air.l  Clini- al  Siirgerv,  jeffer- 
son  Medi.al  lolbt;..  I'hil.i       40  .  olored  plates.    .7S   text  .  uts.  and    410 
Kiu.s  of  t.'vl       Cliiih,  .<!  so  net.       /'i  S.iii'I.Ak'   ,!//.;>  .S,'/,>. 


SrRCERY  A\n  ANATOMY 


13 


Lewis'  Anatomy  and  Physiology  for  Nurses     Just  i»ued 

Anatomy  and  Physiology  for  Nurses.  V<s  l.iRov  Liwis,  M.  I).,  Stiit;c.M 
to  and  Lecturer  on  Anatomy  and  I'hysioloj;y  for  Nurses  at  the  Lewis  Hospital, 
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lony  i-xisted.  Dr.  Lewis  h.is  ti.iM-d  tin*  plan  aiul  sropi'  t»f  Itin  Wi-rk  "ii  iti.-  ni-  thinh  -  ni  ■ 
pU.yi'il  by  liim  in  liMcliinj;  llirsi'  lir.iiulif.,  making  the  It-xt  unu^nallv  sini|ilo  .iml  1  liar. 

Nunei  Journal  of  the  Pacific  Co&it 

'■  ll  IS  H(U  in  iiny  srtiv  nulimtntary ,  Inn  i  iiiiprthrnsive  in  its  frcrttnn-nt  i.f  tin-  sul-j"  ts  ni  han'i," 


McClellan's  Art  Anatomy 


Recently  Iiiued 

Anatomy  in  Its  Relation  to  Art.  Uy  Ci  -^k  McCi.f.i.i.av.  NLD..  Professor 
of  .Anatomy,  Pennsylvania  .■\<a(i<my  of  :,v  r'ine  .Arts,  (Mi.iilo  volmne,  v  In 
12 '2  inches,  with  338  original  drayvin^s  and  photo>;raphs,  and  jf>o  pa;;(s  of 
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Howard  Pyle,  '"  ''''■'  I'hihi././p/iiti  Mi.iu.il  /,>iiin,il 

"  i  hf  I'MMk  is  nil.'  Ml   itn-  lifst  an.l  l.H'  ..msl  ll iiyh  tivt  I ks  >>f  aiti-        .iiiatnmv  win-  li  it  li.is  \f  \y 

the  wiitt-r  •*  Icrlune  t.i  lalt  upun,  and,  as  a  trxl-bo.ik,  »  ..ukIu  to  make  itt,  way  iiitu  Iht  lit-lil  l-i  wlmh 
it  in  intrndeil." 


Senn  on  Tumors 


Second  Reviled  Edition 


Patholofcy  and  Suriclcal   Treatment   of   Tumors.      L>    Nn  lifi  \^    ^i  n^ 
M.I).,  I'li.l)..  LL.I>,.  I'nifessiir  of  Siir.nciy,   Kush  Medii  .il  '  flic;;"',  <  Ima-o. 
Handsome  tntavo,  71.S   pi-cs.  with   47H   en-iaMn-s.    int  liidnv.;    1 -•   lull  pa-e 
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Journal  of  the  American  Medical  Auociation 

■■111.      IIMSI     1   vIl.lll.tiM-   -r    .IIIV    1 "I     I k     I"      K|i„ll~tl    I. II     till 

(li.nlill.ss  i.niain  as  llic  |iriii.  ip.il  iih.Mi.traiili  ..n  111.    sill  j.  ■  t  (.« 

Senn  Practical  Surgery 


II  illiiMiaU'l  .Mi'l  1 


Bated  on  Dr.  Senn'i 
2J  Yean'  Experience 

l>ractical  Surgery.      A  Work  foi  the  1  .tnetal  T'r.n  iitiim  1       liy  Ni 1  \- 

SlN-s,  M.  1).,  I'M.  I).,   LL.  I).,  I'tofessor  if  Siir}.;er\   in  Kusli  Medu  .\I  I  illei;e. 

(  hii  ano.      (Vtavo  of    1113   pajjes.   with  '150  illiisiiatinns.   many   m   lolnis. 

Cloth. *6, 00  ;   Sheep  or  Half  Moroi  ro,  57.00  net.  SM  hy  Siih'i,  fif>li,>n. 

■  It  fi  i)f  value  not  onlv  .is  pn-vnlinj:'  "niprfln'nsivrlv  I'n-  1110  1  •  ;>  .in.  ,d  !•  c  1  ini;-  ■■( 
iii.Mlirn  sunjiTV  in  the  siibjrcts  wliiili  il  t.ikfs  itp.  hiit  ;ils.i  a  n  re.  m  •(  tin-  in  itnml  ..pm 
ions  .ind  pratiicf  "( .in  an  ninplisli.'il  ami  t-\p.ri.  nifil  siii^ion        .1    •  i/i    /  .s»<.4-».i- 


Macdonald's  Dia|(nosis  and  Treatment 

A  Clinical  Text-Book  of  .Surgical  UlngnosU  and  Treatment.     I'v  I    W 

MA(  |H.\  VI  11,  Mil.  I  dm  ,   I.K.(  .S.  ^  l-din  ).  I'l.iffssii,   I  menliis  t,t    ilu-  I'lai 
tire  of  Siiri:>ty  ami  nf  '  liniial   Siir',^ery  in  llamlinc  I  niveisiis     Minne.ipolis. 
(Ktavo,  7((«  paues,  illtis.      (loth,  55  ihi  net  ;   Sheep  or  Hall  M.t  ,  *■<<  0,1  n.l 


sjygaK^ 


M 


s.tr.\7i/:A's'  /.vu)A'.s-  ox 


Haynes'  Anatomy 

A  Manual  of  Anatomy,  liy  Ikv-fnc;  S.  Havnes,  M.D.,  Professor  of  Prac- 
tical Anatomy,  Cornell  University  Medical  College.  Octavo,  6So  pages, 
with  42  diagrams  and  134  full  page  lialf  tones.  Cloth,  Jti.so  net. 

"  This  txMik  is  the  work  uf  a  pt;n  tiral  instructor — one  who  knows  bv  expt'riftue  tlif  require- 
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way.'-  7A<-  Medical  Ketoul,  .^Va■  Votk. 


American  Pocket  Dictionary  rourth  S^vUeMtion 

The  American  Pocket  Medical  Dictionary.     I.>iit.  il  by  \V.  A.  Newman 

DoKl..\Ni),  ,\.M.,  .M.D.,  Assist, lilt  Obslrlriciaii,  Hospital  of  the  University  of 
Pennsylvania,  etc.  566  pages.  Kiill  leather,  limp,  with  gold  edges,  $1.00 
net ;  with  patent  tlmnil)  index,  J1.25  net. 

"  I  am  struck  .it  once  with  admiration  at  the  compact  size  ami  attractive  exterior.  I  can  reiom- 
meml  it  to  our  students  witlioiit  reserve."-  Jamks  W  H*ti  iank.  M.I).,  t^ofeliot  of  Medtfal 
C/iemnliy  "rit  J\rl  irolm'v.  Ml   l/ir    J.;^;  ■  wn  .1/.  .IJ..1/    tcK.ic,    /■lii:.iji/^''ii,i. 

Beck's  Fractures 

Fractures,  liy  Cakl  Ukck,  Ml).,  Professor  of  Surgery,  New  York  Post- 
giadnate  Medic.il  .School  and  Hospital.  With  an  Appentlix  on  the  Practical 
Use  of  the  Rijntgeii  Rays.     3^5  pages,  170  ilhislralioiis.  Clotli,  $3.50  net. 

■'  The  use  of  the  ravs  with  itstechtiic  is  iully  cxpl.iiiied,  and  I  he  practical  [hiints  are  brought  out 
with  a  thoToURhiiess  that  ineiits  hi«li  praise.  "      T/if  Mntuai  AVcc*./,  AVw  Yofk. 

Barton  and  Wells'  Medical  Thesaurus  Recently  inued 

A  Thesaurus  of  Medical  Words  and  Phrases,  lis  Wii  n<i n  M  IUkkin, 
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lurcr  iin  I'haniiai  v.  1  ;ccir>;<'tii»  n  1  nivcrsltv.  \\'asliin.L;tim,  I  >.  C.  ;  and  W  M  i  IK 
.\.  Will.s.  M.l>..  I  iciiiiinstratir  of  Uir\  n.u;M|ii.4y,  Cicid-elnwn  Cnisersity. 
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thiniili  iiulcx,  *  vi"""  net. 


ra*i: 


_ ,  t      c>        ^<        •    «i«       t.     •  Recently  liiued 

Stoneys  Surgical  Tecnnic  New  (2d)  Edition 

BacterioloKy  and  Surgical  I'echnic  (or  Nurses.  Hv  I  mm  \  M.  A.  Stum  v, 
Siipcnnloiidem  at  the  t  ainrv  llusj.ii.d.  Smith  lioston.  Mass.  Revised  hy 
Vhi  111  Kic  K.  (.1(1111111.  M.  1>..  Surgeon,  of  .New  Voik.  unio,  20(\  pa^cs. 
iUustiatcd.  »l-50  "»^' 


"  These  subji-i  ts  ate    lieali,i    most    ,t.  t  lirati  U  ■ 
which   1-    %.■   "lien    cinpl.o.d  Nuisc 

7't,Uft'-.l   \lti  S'    and  //■"/  If^lf  A*.  ;*..' 


id  in.  lo  d.itr.  uith-iul    lb.    slipeltlu,ms   leadinR 
will    liiid  Ihis  lK,ok  ol  ihe  ,;leutest  value." 


Grant  on  Face,  Mouth,  and  Jaws 

A  Text- Book  ti(  the  Surgical  Principles  and  Surgical  Diseases  of  the 
Face,  Mouth,  and  Jaws.  I  ..i  Denial  .Stiidi  iits.  jiv  II,  Huu.v.  1  (.kant, 
A.M.,  M.r>..  Professor  oi  Surgery  and  of  Cliiinal  Stirger\,  Hospital  College 
of  Medicine.     Ocl.ivo  of  2,v  p.igi-,  with  (.,S  illustrations,       Clotli,  |i  so  net. 


"  The  latlKuace  of  the  l»iok  is  oimplc  and  .  Icai 
whom  II  IS  intended        1'hil.iJttfkia  Mrdnjl Jtmintl. 


We  recommend  the  woik  to  thow;  (or 


Khm.' 


SUKGF.R  V  AND  ANATOMY 


>5 


Preiswerk  and  Warren's  Dentistry  just  i»ued 

Atlas  and  Bpitome  of  Dentistry.  I!y  I'kium;.  I'ki  iswi  hk.  ,,f  i;,isil.  I  <| 
itcd.  with  additions,  by  (;i;(>i«.K  W.  \V auri  n.D.D.S..  I'n.fi-sor  nf  Opoialuf 
Dentistry,  Pennsylvania  Collej^e  iif  1  )cntal  Siirj^cry,  I'liil.iili  i|)lii:i.  With  44 
hthosraphii:  phites,  152  text  <  iits,  aiul  343  pa-,  >  of  text.  Lh.lh,  #3  50  net. 
/«  Siiutitiirs'  Alias  \ii,s. 

"  Nowheri"  in  ilental  lilprallirc  linvf  \n-  ivi  r  scrn  illustralior.    wliic  l\  r  m  l"gin  I..  (  nmiMrf 
Willi  thecMiuisite  colored  plati's  proiluteil  in  Ihii  volume." — Pcntul  h'ezitw 


Beck's  Surgical  Asepsis 


A  Manual  of  5urKical  AsepRis.      !'■>    l  \ki     Diik.   M,  |i.       '   1  p-'^:''^  >  ''^ 

text-ilhistratiuns  and  12  full-page  plares.  (,  loiji,    >i   .-j  Tin 

"The  tuM.k  is  well  wiiui-n.  The  data  are  tli.uK  ;uhI  rnticisfly  Rivi-ri.  The  facts  ai,-  well 
arraiiKid.  Il  is  well  worth  readinK  to  Ihe  s.ud.  1,1.  ihe  phvsieian  in  general  practiee,  and  the 
surge* »n."—/>'c'j/fjif  Aff-ttica/  ami  Suiv:it:al  JumnaL 


Griffith's  Hand-Book  of  Surgery 


Recently  Iiiued 

A  Manual  of  Surgery.  Hy  I- itian  un  K.  ('.mil  rrii,  M.  I>  ,  Siirj,'eon  to  the 
Hcllcviie  Dispensary,  New  ^■()rk  City.  i,;ino  of  57^  pa:.;es.  with  4i7ilhis- 
trations.  Ilcxililc  leather.  »;;.oo  net. 

'*  Well  a'lapled  to  the  needs  ..t  itii'  stii'l'-ni  .iii.i  in  the  tie^y  [ins  miuiicf  for  a  hasty  review  of  iniiH-rtanl 
points  ill  surjfery." — Aniii ;.  UH  ,1/r.//,  iHi . 

Senn's  Syllabus  of  Surgery 

A  Syllabus  of  Lectures  on  the  Practice  01  Surger-'  Arranged  in  con- 
formity with  "American  Text-llook  of  Surgery."  I'.y  Ni(;mol.\s  Sicnn, 
M.D.,  Ph.D.,  1.I..D.,  Professor  of -Siirijery,  Rush  Medii.il  Collc>;e.  Chicat;o. 

Cloth,  $1.50  net. 

"The  author  Ii.is  e\  ,(i,  nil y  v|  1.(1  td  no  pains  in  in.ikint;  his  S\tl.iliii-.  Ihoion^hlv  i  ompiehenstve, 
and  has  ailileii  new  inatloi  and  .ilhided  to  the  most  recent  anlhui^  .lod  oiu-iatmns.  l-iiU  leter- 
ences  an-  also  >iiveii  to  all  lequistii  itetailsof  surgical  anatomy  and  pathology." — Hulish  Mrdv 
cat  Journal. 


Keen's  Addresses  and  Other  Papers 


Recently  Ittued 

Addressc-- and  Other  Papers.     Drliwrnl   '.\    Uiiiiwi   \\ ,   Kmn,   M.  D  , 
IIP.  ■<.  t.  S.  (llonV   I'lnfessni  it  Ihe  I'nni  iplis  of  Ntn    ir\  ,iiiil  id'i  Im 

ical   Surgery.    Uilersun    Medii.il   t  i'lle:,;c,   I'hilaiklphi.i.       iht.i-'   M.lnnie  of 


441   |iaj;es,  illtistiated. 


Chilh, 


Keen  on  the  Surgery  of  TypKoid 

The  Surgical  Complications  and  Set^uels  of  I'yphoid  lever.     Ily  \\  m.  \V. 

Kkkn.  M.D.,  IT.D,,  K.R.C.S.  (Hon.),  Professor  o<'lhe  Principles. d■^lll^;cly 
and  of  Clinical  Smoery,  Jefferson  Meilical  Collej.:e,  I'hiladelphia,  etc. 
Octavo  vohime  of  386  pa^es,  illiislralctl.  Cloth,  S3  <x>  net. 


"  Kvei  V  siiii:i<  .d  ln<  dent  \^  htch  can  m  1  nr  dnimg  01 
hilly  illnsliiied  hy  inses  .  ,  .  Tile  IkkiW  will  In  1 
The  I'laclitumt't ,  Lom4en. 


Ill  r  l\phoitl  lever  is  .iinptv  disc  nssed  alld 
eliit  iKrth  to  Ihe  suige»<n  ,uul  physician."^ 


m^i. 


i6 


SiRGERV  AND  ANATOMY 


Moore's  Orthopedic  Surgery 

A  Manual  of  Orthopeclic  Surgery.  By  James  K.  Moork,  M.D..  Professor 
of  Clinical  Surgery,  University  of  Minnesota,  College  of  Medicine  and  Surgery. 
Octavo  of  356  pages,  handsomely  illustrated.  Cloth,  $2.iiO  net. 

"Thtb(X)k  iseniincnllv  pradiial.  It  i-  a  safe  cuidc  iti  the  uii<Urslantlinc  anH  Ireatimiit  ot 
orthoiiedic  cases.    Sliuulcl  be  owned  '..y  every  surKei.n  ami  pracliliuner."— .(»i>iu/s  0/ .VioiT^'O'- 


Fowler's  Operating  Room 


Juit  Iiiued 

The  Operating  Room  and  the  Patient.     Ky    Ki  ssi  t.i.  S.   Iowiik,  M.  1). 

Surgeon   to   the  (".erman    Hospital.    Brooklyn,    New   York.      Octavo   of  172 

pages,  illustrated.  •-  >"th,  *2.oo  net. 

Dr.  Fowler  li.is  wrilti-n  his  1)1... k  f.ir  siirs;i-..iis.  muse- .is^i-lin!;  .it   ,111  ..peralinn.   interne>. 
,111.1    ill  ..ih.  r- wli..-.e  iliilies  tjrini;  them   inl.i   tl.i    cpenitlTit   i....iii       It   eontams  explicit 
ilir.-.  lion- f..r  tlie  pi.  p.iration  cif  in.iten.il.  in~tniin.nl-   n.i.leil,  p..~iticm  iif  patieni.it. 
all  heautiftilly  iliu.^tr.ite.l. 

Recently  lijued 

Nancrede's  Principles  of  Surgery      Ne*  (2d)  Edition 

Lectures  on  the  Principles  of  Surgery.     I!y  Cii as.  H.  Nanckf.dr,  M.U., 

I.1..I).,  I'rofcssor  of  Surgery  and  of  Clinical  Surgery,  University  of  Michigan, 

Ann  Arbor,     fktr.vo,  407  pages,  illustrated.  Cloth,  S2.50  net. 

•■VVecan  stn.iiKK  rec.miiKiid  this  hii,,k  to  all  Murlciiti;  anil  lh.se  wh.  m.uIiI  see  si.m.lhinB 
of  the  scienlilic  foundati1.11  .i|K)n  which  the  art  of  smuerv  is  lunll."— (.'kui  '  ly  M.-ilniilJ^nn  tuil, 
ShiffiFld.  l-.Mglaiid. 

Nancrede's  Essentials  of  Anatomy.    ^""th'Edition 

Essentials  of  Anatomy,  including  the  .Anatomy  of  the  X'iscera.  ByCiiAS. 
H,  NaNihkhi;.  M.U.,  Professor  of  Surgery  and  of  Clinical  Surgery,  University 
of  Michigan,  Ann  Arbor.  Crown  octavo,  3K8  pages;  180  cuts.  With  an 
Appendix  containing  over  60  illustrations  of  the  osteology  of  the  body.  Based 
on  0><m' t .  ;»<f A>«n'.         Cloth,  Ji.iMnet.     /ii  S,ii()i,/,rs    (Jii,sf/,>n  Ci'mpi-n./s. 

:\  concisely  (;i\cn."-- 


"  The  nuestions  ha\e  lieeil  « i.elv  selected,  anil  the  answers  accuratel 
t'niTrt sily  Mi-diial  Ma^itiztttc. 

Martin's  Essentials  of  Surgery. 


Seventh  Fldition 
Revised 
Essentials  of  Surgery.  Containing  also  \  ciieieal  Diseases,  Surgical  Land- 
marks, Minor  and  1  i()crati\e  Surgery,  and  a  complete  description,  with  illus- 
trations, of  the  ll.iudkcrchief  and  Koller  liandages.  Uy  Kdwaki)  M  vktin, 
A.M..  M.D.,  I'rnfessor  of  Clinical  Surgery,  University  of  Tcnnsylvania,  etc. 
Crown  octavo.  338  pages,  illustrated.  With  an  Appendix  im  Antiscjiiic  Sur- 
gery, etc.  Cloth,  51.00  net.      /«  S,iii;u/,rs'  (Jiieslhn  (i>inf<ctiiis. 

"Wiitten  to  assist  the  student,  it  will  he  of  ni.  I.umecl  value  to  the  pra.  litionei.  .oritainiriK  as  il 
does  the  essence  of  suiRiial  «..rk."— /;..JA.»(  .\/,'linil  iiiuf  Snificiit  Joniniil. 

Martin's   Essentials  of  Minor  Surgery,  Band- 
aging,  and  Venereal    Diseases.      *""£i|?;r'"'' 

H8.sentiais  of  Minor  Surgery,  Itandaging,  and  Venereal  Diseases,     lly 

KiiwAUh  Mmiiis,  a.m.,  M.I).,  I'mlcssur  of  Cliiic  ,il  Surgery,  University  of 
Pennsylvania,  etc   Crown  octavo,  1C16  pages,  with  7S  illustrations. 

Cloth.  < 1. 00  net.      In  S,vin,i,rs'   Ou,slwn  i'nn  '  w-'v 


"The  hiM  londensalion  ..f  tin    siihieits 
Tht  Mt-Hxiat  .%>«  .1,  I'hilaitflpkm, 


of  will,  h  it  Heals  >rt  pl,lceil  helorethe  pT..lessio»  ' 


MM 


^ 


